Can Germs Keep Us Healthy?

What's trickier is how to add back the good guys without the bad. No rational person would want to go back to the bad old days of unsanitized water and epidemics of cholera, typhoid, and dysentery. Probiotics are a start, but only a few have been tested and that's been enough to show us that they're not all created equal. If you're going to lay down good money for a probiotic, I'd look for labeling along the lines of "clinically proven to be effective to do WHATEVER."
_______________________

Waverly, WV: What is the most important action the ordinary citizen can take to prevent overkill of the beneficial bacteria, while protecting ourselves from the harmful ones?
Jessica Snyder Sachs: Initiate a discussion with your doctor when he or she prescribes an antibiotic.

First, ask whether you really need an antibiotic? Many doctors still tend to overprescribe with a "just in case" attitude, even in situations such as viral upper respiratory infections and uncomplicated ear infections—where new medical guidelines now advocate careful "watching and waiting" before prescribing antibiotics.

Second, if you need an antibiotic, ask your doctor to prescribe one that's least disruptive to your "good bacteria." Again, many doctors needlessly reach for the "big gun" antibiotics, when a more targeted "sniper bullet" would do the trick.

Oh, and one more thing: From what I've learned, I strongly recommend avoiding antibacterial soaps and cleansers containing triclosan or triclocarban. Research shows that these chemicals work like antibiotics, unlike, say, alcohol or bleach, which simply obliterate microbes on contact. We know that triclosan promotes drug resistance in test-tube bacteria. Will it do so in real life? We don't know. But studies show that consumer products containing these antibacterial chemicals don't prevent infection any better than does ordinary soap and water. So if there's no benefit, why take the risk?
_______________________

New York, NY: Can you tell us about some of the most interesting research being done in this area? Any particularly groundbreaking experiments or scientists?
Jessica Snyder Sachs: By "this area" I'm going to assume you mean our designated topic, "How Can Germs Keep Us Healthy?" As I mentioned, Jeffrey Gordon, at Wash U, is doing fascinating research. His graduate students use DNA microarrays to follow the genetic and biochemical chatter that goes on between intestinal bacteria and cells in the body. His lab is probably most famous now for the finding that some microbes direct our abdominal cells to store extra calories as fat. This may have helped save people from starvation in leaner times. Clearly, our intestinal bacteria have other functions in addition to helping us extract and store calories. We need more research on how they prime our immune system and perhaps reduce our risk of cancer, especially colon cancer.