Changing a Paradigm: Have We Simply Used the Drugs in the Wrong Way?

Sep. 30, 2020

Last week, the number of deaths caused by COVID-19 in the U.S. surpassed 200,000. Underlying or “modern” diseases, such as diabetes, cardiovascular disease, and malfunctions of the immune system, are a leading cause of the severe illness and death outcomes with COVID-19. So, what caused the surge of these diseases and, consequently, the susceptibility to severe outcomes with COVID-19? According to professor of food science and microbiology Hua Helen Wang, the answer lies in our gut.  

The gut is home to trillions of bacteria, many of which are essential to keeping us healthy. Numerous studies have connected damaged gut microbiota with malfunctions of the immune system and various underlying diseases. Emerging evidence further illustrates that disrupted gut microbiota rich in opportunistic pathogens is typical in severe COVID-19 cases.

In 2013, Dr. Wang and her team published research revealing that taking antibiotics by mouth massively and unnecessarily kills essential bacteria and increases the number of antibiotic resistant genes in the gut. In a new paper published in July 2020, the team further illustrated that when an antibiotic was given orally, in addition to disrupting the healthy microbiota, it actually enriched the opportunistic pathogens in the host gut, which pose additional health risks. Further, Wang’s team found that microbiota transplants, which are intended to repair microbiota damage, can introduce additional risks. Thus, protecting the original healthy gut should be a priority when making healthcare decisions.

There is good news—simply changing drug administration to injection significantly alleviated these microbiota problems. “Historically antibiotics were given by muscle injection. As industrialized countries began adopting oral antibiotics, antibiotic resistance and a growing list of modern diseases associated with gut microbiota disruption shared similar rising trends,” Wang explained. Accompanying Wang’s initial publication in 2013, the news release by the American Society for Microbiology predicted that this finding would address not only antibiotic resistance, but likely a series of modern diseases. At that time, scientists were beginning to realize that there is a connection between diseases such as diabetes and the functions of the gut microbiota.

Today, as many as 350 million antibiotic prescriptions are given annually in the U.S. alone, and most are administered orally. “Who doesn’t have a kid or know an adult who has needed antibiotic treatment, whether for mid-ear infection, a dental procedure, strep throat or other infections? We must realize the long-term damage of oral antibiotics to our health. The severe outcomes of COVID-19 won’t be the only consequences,” Wang said. When asked what she needs to shift the paradigm of oral antibiotic administration and effectively save lives, Wang’s response was quick: funding for more investigation and the proper platforms for her and her colleagues to disseminate knowledge and facilitate the necessary changes in policy and practices. “With 30+ antibiotics historically being used worldwide by injection, it shouldn’t cost a billion dollars or take too long for improvement,” Wang urged. As the risks associated with underlying diseases become more visible during the COVID-19 pandemic, there is no time to waste in initiating these changes.

 

Contact: 
Hua Wang, Professor
Wang.707@osu.edu

Molly Davis, Scientific Editor
Davis.2020@osu.edu