 Hey everybody, Dr. O. In this video, I kind of want to dive in and just talk about the pros versus the cons of using broad spectrum antibiotics. So let's start with the definition. So a broad spectrum antibiotic is an antibiotic that can kill a broad variety of organisms. So typically that means that they can kill both gram positive and gram negative bacteria or at least inhibit them both. So what would be the benefit of using broad spectrum antibiotics and why were they used so much in the past? Well, if you don't know what pathogen someone has, then a broad spectrum antibiotic is basically a shotgun approach. You're more likely to hit it. But the problem is now that they do more specific research on the type of antibiotics we choose versus the type that will end up working once we have actually culture the organisms and use things like antibiotics would say that only about 35% of the antibiotics we choose when we use this shotgun approach are actually going to be the most effective kind. So that's generally the rationale behind using them is that you're more likely to catch the microbe that you're trying to kill. So these were used a lot in the past. They still are used probably way too much. But in the past, excuse me, I'm sorry, we didn't understand that there were consequences to using antibiotics besides just the evolution of drug resistant organisms. We also had damage to the microbiome, et cetera. So let's look at those cons. So the pros would be that that you're hopefully more likely to actually kill the pathogen. But the con is you're going, there's going to be a lot more collateral damage. That's the way I look at it. Broad spectrum antibiotics are like firebombing an entire city, whereas a narrow spectrum antibiotic or maybe something in the future like phage therapy would be like a laser guided missile strike for the one target that you need. So you look here at number one, the normal microbiota keeps opportunistic pathogens in check. So an opportunistic pathogen is one that generally isn't going to be a pathogen in a strong host. It's going to be a pathogen in a compromised host, a weak host, or if it gets in the wrong location. So here we see the benefit of having a good microbiome. I mean, they make vitamins, they do all sorts of cool things. But if you ask me, the number one benefit of having a strong, healthy, robust microbiome is a term called competitive exclusion. So as long as your microbiome is full of good organisms, they hold the bad ones in check. And we say that a perfect microbiome is still only 80% good bacteria, 20% bad bacteria, but those good bacteria are what hold the bad ones in check. So here we see at number two, now a broad spectrum antibiotic has came in and wiped out all of these drug-resistant organisms' competition. So imagine that blue organism being C. diff. This person had C. diffs been inside their gut for 25 years, and now they take this broad spectrum antibiotic, kills off all of C. diff's competition. C. diff's been hanging out in spores, waiting for the environment to change. And now it's like, oh, there's tons of food around, there's no competition. C. diff will regenerate, these spores will regenerate, they'll become vegetative cells, and now you have a C. diff infection. This is the reason that antibiotics lead to things like C. diff infections. So and that's what number three says, drug-resistant pathogens proliferate and cause a super infection. So a super infection is an infection caused by taking antibiotics. So it's a type of secondary infection, but it's not like because you're a compromised host. It's not like because you have the flu and your immune system got weak, that you got pneumonia. It's because you took antibiotics, it killed off all the good, quote unquote good guys, that were holding the bad organisms in check, and then now they're able to take over. So the most common examples of super infections would be C. diff. If you've ever smelled C. diff, you'll never forget it. And number two would be Candida yeast infections because antibiotics, even broad spectrum antibiotics don't kill yeast. So this is the rationale behind using broad spectrum antibiotics, but also the cons, the negatives associated with it. Now in the future, I hope that these broad spectrum antibiotics are absolutely only used when necessary. So how do we do that? Number one, quicker diagnostics. We realize that we chose the wrong antibiotic all too often, but it takes one, two or three days to figure that out. So using things like phage typing or genetic testing, hopefully we can tell what organism someone has quicker. And then number two, using things like antibiograms, not only do we know the organism, but where can we get data to say this is the antibiotic that's the right antibiotic to kill this organism without all this collateral damage. Then I'm also hoping that in the future we have narrow spectrum antibiotics that are very specific. Like if you have a helicobacter pylori infection, there'll be an antibiotic that hopefully just kills that organism. Well I'm not sure, and I'm not sure if it'll be antibiotics, but so in the future I hope that we do not see this abuse, misuse, and overuse of broad spectrum antibiotics because of this is one of several complications. All right, I hope that helps you understand kind of the rationale behind being concerned about the use of broad spectrum antibiotics. Have a wonderful day. Be blessed.