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Comment by TaupeRanger | Hacker News Reader

And yet, there is no evidence at all that people who take more antibiotics live shorter or worse quality lives...so does any of this really matter at all?

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Absence of evidence is not evidence of absence. We have pretty strong data that suggests that antibiotic exposure is associated with negative health outcomes. For example, patients who had undergone antibiotic exposure within a 6 month period preceding their admission to the ICU had a 20% increase in mortality rate.

Another study [1] I just found showed that older women who had been exposed to antibiotics for => 2 months had increased risk of all-cause mortality and cardiovascular mortality (hazard ratio 1.49). Interestingly, if they had also been exposed to antibiotics in middle-adulthood, their mortality rate was even higher; which may suggest that antibiotic exposure permanently impairs the microbiome. Paper's conclusion: "Long-term use of antibiotics in late adulthood may be a risk factor for all-cause and cardiovascular mortality. The unfavorable effect of antibiotic exposure for subsequent risks of deaths due to chronic diseases needs to be considered."

[1]: https://pubmed.ncbi.nlm.nih.gov/31842690/

All I'm seeing from the two examples you gave are situations where sick people got sicker and died.

It's almost trite to say it at this point but correlation is not causation.

> For example, patients who had undergone antibiotic exposure within a 6 month period preceding their admission to the ICU had a 20% increase in mortality rate.

That seems like a very obvious case of correlation vs causation (people who need medicine are more likely to die than those who dont)

Kindly don’t say stuff like this. After taking antibiotics I had severe, severe anxiety that lasted months along with insomnia. Now the anxiety is mostly gone but I’m still dealing with some sleep issues. If you google antibiotics anxiety microbiome you can read a bunch of studies.

Kindly do not cite personal anecdotes as evidence.

Kindly do your own research instead producing spam answers.

Sorry. Anecdotes are not useful or instructive here. No studies show a causal effect of antibiotics on anxiety. In fact, it wouldn't be surprising if people who needed medical treatment (causing an antibiotic Rx) later had anxiety due to the nature of their health condition.

There are quite a few studies done on mice where they show this.

Okay, what are they?

- https://pubmed.ncbi.nlm.nih.gov/26580313/

- https://pubmed.ncbi.nlm.nih.gov/35027429/

- https://pubmed.ncbi.nlm.nih.gov/35243408/

- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6879739/

- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8000835/

- https://pubmed.ncbi.nlm.nih.gov/33676528/

Note, some of these are studies of humans and some are on mice

Sorry, none of these establish causality, only very mild (probably specious) correlations. One of them is only in cancer patients which is basically worthless when discussing the general population. The rest are in mice, which doesn't translate to humans in general, especially not where psychological issues like anxiety are concerned. There is definitely some possibility for future research though. Even a single replication of any of these studies would be helpful. But so far there's no reason to think a causal link exists.

I agree that causality isn’t established in the human studies. But with the population studies and the mice studies where causation is established that is a strong suggestion for further research as you said. If I were a betting man I would bet a lot of money on this link though, based on my experience and these studies (and there’s more). I think you would too, to a lesser extent :)

And I’m pretty sure one of the human studies does establish causation, although I don’t have time to see which one

It is somewhat rude to speak in imperative ("don't say stuff like this"), and it is completely non-informative. If you disagree with someone, stating your reasons is much more likely to change others' mind than speaking in imperative, which only makes you look like a bully ("don't say stuff like this or I'll take your lunch money").

The commenter prefixed with "kindly" which is about the same thing as saying "please". This makes it not imperative, but a request.

I'd assume the person you are talking to is not a native speaker. I think Indians use language that might sound rude or passive aggressive.

Interesting, I haven't considered that. I'm curious whether the form of talking (assuming the poster is Indian) is caused by language structure or culture.

Still, I hope that my post was received by the poster as informational, despite its somewhat harsh tone. No matter your background, knowing how to present your ideas in a non-confrontational way will surely make more people listen to you.

You know where half of the worlds antibiotics go to? As growth promotion on animals. Growth promotion => obesity => metabolic syndrome => diabetes => shorter life (diabetes basically being accelerated aging disease)

Please, this should be primary school knowledge nowadays.

I was obviously referring to humans taking them, just as the person I responded to was. Please.

Humans eat animals. Humans are animals. Please.

Try to keep up. The person I responded to was specifically talking about humans ingesting antibiotic medicines, so my claim was responding directly to that behavior. If you want to try to prove that cows taking antibiotics makes humans more obese than they otherwise would be, that's fine but it has nothing to do with the original claim about human medicines.

Even relatively short term use of antibiotics can result in digestive issues lasting multiple years. Auto-brewery syndrome for example is linked to antibiotics and can seemingly persist until treatment by antifungals.

Of course. Yet still, there is no evidence that these people would live shorter or worse lives than if they hadn't taken the antibiotic. What if the infection they took the antibiotics for had caused more harm than auto-brewery syndrome? What if the unchecked infection caused problems that couldn't simply be solved by antifungals? My point was just that the person I responded to seemed to imply that antibiotics are very bad except in cases where they save your life, which is not really supported by current medical knowledge.

Couple of comments replied mentioning studies in this area, and you dismiss them completely (i.e. you show no indication of any value assigned on points made). Seems like you have very strong beliefs/faith/stake in using antibiotics as tic toc.

Literally none. Please point out a study done in humans that was posted. I'll read it to see if a causal effect is shown in humans.

There are a lot of such studies but if you really just one one example I will pick one at random: https://link.springer.com/article/10.1007/s00248-007-9356-5

Let me guess you’re going to move the goalpost.

That’s assuming the antibiotics where needed, overprescribing them is extremely common even with viral infections. Peoples immune system can deal with the vast majority of bacterial infections, it just takes slightly longer than a trip to the doctor.

From a doctors perspective prescribing antibiotics encourages people to show up with minor illness, it’s bad medicine but good business practice.

That’s like saying “people who get cancer drugs die earlier”.

Who did you think you were replying to? I implied no such thing and the comparison to my comment doesn't even make sense.

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