Microbiotoxicity: a call to arms for cross-sector protection of the human microbiome

Abstract

Carpenter et al.’s recent study adds to the growing body of evidence showing that antibiotic use can be harmful to the human microbiome.1 We recently introduced the term “microbiotoxicity” to describe unintended harms of antibiotic therapy to the microbiome, proposing a framework for prescribers to weigh these bystander effects against intended therapeutic benefits.2 However, it is becoming increasingly clear that microbiotoxicity extends far beyond antibiotics, encompassing non-antibiotic pharmaceuticals,3 dietary additives,4 and biocide-containing consumer products.5 Indeed, antibiotics are only one of a panoply of commonly used antimicrobials. The distinction between antibiotics, antiseptics, disinfectants, and sterilising agents lies primarily in the substrate to which they are applied: internal aspects of bodies, external aspects of bodies, surfaces, and inert substances, respectively (Fig. 1). Thus, all products with antimicrobial properties may cause unintended microbiotoxicity.

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Identifiers

ORCID for Anastasia A Theodosiou: orcid.org/0000-0002-0096-4825

ORCID for Robert C Read: orcid.org/0000-0002-4297-6728

ORCID for Christine E Jones: orcid.org/0000-0003-1523-2368

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