Researchers Urge Caution in Using Antibiotic Prophylaxis

The medical community has for long relied on antibiotic prophylaxis, the practice of prescribing antibiotics to safeguard at-risk individuals from bacterial infections. However, a new publication has sounded the alarm on the widespread use of these “just in case” treatments due to their risk of driving antibiotic resistance. 

The paper, published by researchers at Charles University in Prague, appeared in the Clinical Microbiology & Infection journal. The authors caution that the prophylactic use of antibiotics has become unsustainable due to its growing use by medical practitioners because it threatens the long term efficacy of these medications. As more people use these therapies, the risk of antimicrobial resistance is growing, they say. 

Doctor Marek Stefan, the study’s co-author, explains that the use of antibiotics for prophylactic purposes imposes immense pressure on the microbiome within patients and speeds up the development of pathogens that are resistant to these treatments. 

The authors of the paper make reference to several clinical scenarios in which antibiotics are routinely given for prophylactic purposes but could potentially promote the rise of antibiotic resistance. One such example is the use of antibiotics by people who have been exposed to individuals diagnosed with viral pneumonia. 

Few of the contacts of such a person face a high risk of developing the disease, but when they are given prophylaxis, their microbiome is impacted in ways that could later make them resistant to the available antibiotics used to treat bacterial pneumonia. 

Prophylaxis is often also prescribed to prevent bacterial STIs (sexually transmitted infections), and other infections. The scientists cite Dutch data that found that approximately 580 individuals need to receive iGAS (invasive Group A Streptococcus) prophylaxis if just a single secondary infection of this condition is to be prevented. 

Those numbers don’t make sense when one considers the heightened risk of enabling antimicrobial resistance, the researchers say. 

They therefore caution that the medical community needs to rethink its position of erring on the side of caution when administering these prophylactic treatments because the long term risks often outweigh any possible benefits. 

The scientists say the current realities call for being cautious in prescribing prophylactic antibiotics so that the existing supply can be protected from becoming ineffective as a result of excessive use for prevention purposes. 

The dilemma that clinicians face is that it is often difficult to detect these infections before they have progressed to a level where they can quickly spread from one individual to another. Perhaps entities like Co-Diagnostics Inc. (NASDAQ: CODX) could be of help in developing accurate diagnostic tools that can be used to identify individuals who are still in the incubation stage of infection so that antibiotics can be selectively prescribed rather than giving these medications to everyone suspected to be at risk of getting infected. 

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