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Comment by bilsbie | Hacker News Reader

One thing I don’t understand.

Don’t most people end up taking a course of antibiotics at least a few times per decade? Why doesn’t that wipe this out?

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Interesting question.

The article says that there are only 8 million people with Parkinson's, so about 1 in every 1,000 person. I wonder if it is possible that only people who have never taken antibiotics after they got the disease is affected.

I’d expect docs would have tried giving these patients antibiotics though, just to see what happens. Maybe once the disease catches the bacteria can be killed off but the disease persists.

Antibiotics have major downsides. Our gut flora is quite important to our health.

A doctor worth their oath wouldn't try giving patients antibiotics "just to see what happens."

I think I was never in my life prescribed antibiotics without a warning that I have to take probiotics after each dose. Same at the pharmacy when buying prescribed antibiotics - there's always the "need probiotics as well or do you already have some?" question.

My grandfather had Parkinson's and definitely had antibiotics many times after his diagnosis, didn't help at all. After one particularly nasty infection+strong antibiotics, he got much worse overall.

I am very likely to have Parkinson's too, had antibiotics many times. Didn't change a thing about my tremor.

In the gut, oftentimes antibiotics clear specific beneficial colonizing bacteria and make room for the outgrowth of pathetic ones. This is the prevailing thought as to why antibiotic use is linked to C. diff, for example.

In some countries, antibiotics are prescribed together with probiotics to ameliorate this. Shouldn't we see a reduction of PD in these countries?

(Also, did you mean "pathogenic"?)

Oh my goodness, yes, I meant pathogenic. What a silly and fitting insult.

I'm not familiar with how effective any kind of prescribed bacterial community recolonization is compared to probiotics or not doing anything.

I think the only FDA approved routes are enema and fecal transfer. I know there are capsule versions in the works, but I don't think they are FDA approved.

I expect that was meant to be "pathogenic" (unless you wanted to hurt the feelings of those rotten bacteria). And yes, it's not a complete reset, just a big reshuffle, so it's certainly a good idea to eat lots of fiber and fermented foods during and after a course of antibiotics to try and re-establish a healthier gut microbiome.

Oh my goodness, yes, I meant pathogenic. What a silly and fitting insult.

Aren't gut bacteria surviving in the appendix, replenishing after antibiotics finished their course?

That is my very rough understanding. They do a number on your gut, and they probably significantly alter the balance of the microbiome, but they don't give you a clean slate by any means.

Not sure what the term of art is for the "poop pills", but feels like something like that would be required here. Maybe specially tailored to out-competing the bacteria in question.

Likely there will be bacteriophages in the environment where the Desulfovibrio arise that target it, those could make for a very specific therapy (assuming the causal link holds).

Even if you can good adherence to antibiotics, without specific targeting, you have always have unknown unknowns that won't be completely eradicated by a broad spectrum treatment. This study is probably finding out how to target.

Antibiotics don't kill every microorganism. Also, our gastrointestinal tracts are repopulated from food we eat and our surroundings.

Oh, and particular antibiotics will cure a certain subset of all bacteria. So if you get pneumonia, you'll be prescribed a different antibiotic to what you'd be given if you had h. pylori. (Actually h. pylori is hard to kill, so I believe you're given 3 or 4 different antibiotics to take over several weeks)

>Don’t most people end up taking a course of antibiotics at least a few times per decade?

A few times per decade sounds too frequent to me. Even once a decade sounds too frequent. I wonder where one could find stats on this.

Specific bacteria is responsive to specific antibiotics. I have a family member who gets frequent urinary tract infections. They always have to characterize the bacteria to see what antibiotic it’s susceptible to, otherwise the bacteria just laughs off the antibiotic.

Antibiotics target certain bacteria and may not wipe all types even from intestines, not to mention rest of the body.

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