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Guide Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues

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In the field of infectious diseases, long-standing and contentious questions surround the proper stewardship of antibiotics. This comes up naturally in the office and the ward, but it is also relevant in agriculture, personal hygiene, and other mass-market settings. The general public and our policy makers need to understand the consequences of antibiotic overuse in 3 ways: 1 as a potential cause of direct toxicity, 2 as a driver for greater antibiotic resistance, and 3 as a perturbation of the human microbiome with unpredictable and possibly severe, adverse consequences.

Fortunately, there are some books that lay out the logical rationale for changing our relationship to antibiotics in a way that intelligent laypeople can understand. There is no one with better credentials to tell this story than Blaser, whose life seems almost custom-designed to address the important questions surrounding antibiotic use and overuse.

Missing Microbes : How the Overuse of Antibiotics Is Fueling Our Modern Plagues - arficalto.tk

But equally importantly, his roles as a writer, editor, public advocate, and teacher and his affiliations with the Institute of Medicine, the National Institutes of Health, and the National Cancer Institute show his pivotal public role and extraordinary communication skills. Missing Microbes is rooted in Blaser's life experience, and this makes it even more powerful in illustrating our oddly conflicted relationship to antibiotics. The book shows the evolving understanding of the balance between the potential acute healthcare benefits and long-term negative consequences of antibiotic use.

His gift for storytelling allows the reader to appreciate the emerging consensus that antibiotics have lingering effects on our lives long after we have taken the last pill. The 16 chapters of this book lay out the intricate relationship between people and the microbial world they inhabit.


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Blaser strikes 2 important balances. The first is the benefits of antibiotics for patients with serious bacterial infections contrasted with the variety of unintended but important health outcomes less obviously tied to antibiotics. The second balance is between presenting a clear and full picture without overwhelming the reader with details.

Although the audience for this book is clearly the general public, I would urge medical students, residents, and fellows to read it as well. The clarity of the explanations and the elegant presentations of the science behind these new observations are useful even for people with extensive clinical experience. The book does not shy away from controversial topics.

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They are laid out even-handedly, but there is a clear point of view. The potential benefit of H. The area that may be hardest to understand is the correlation of the series of experiments showing that alterations of microbiome have an impact on obesity in mice. The experiments are well described, but specific manipulations of diet and antibiotics in mice are somewhat removed from the life experience of most readers.

The book is hard to put down, but try to savor it so that you can fully relish the clarity of the exposition as well as important messages contained within. You may find yourself thinking back to many of Blaser's examples in your clinical work and teaching.


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Are we targeting the wrong bugs? Review of Missing Microbes, a book by Dr. Martin Blaser

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Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues

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