Scientists from the University of Manchester have stated that exposure to antibiotics and the associated "adverse effects on the beneficial bacteria in the gut" could lead to "increased risk of infection". They found that the risk of sepsis, which is fatal in around a fifth of (human) cases, increased with the number of antibiotic courses a person took.

NB. The whole subject of antibiotics is a deep-rooted pet subject of mine, and one I feel very strongly about because due to a dental treatment that went wrong many years ago, I was put on 2 courses of 'very strong' (to quote my dentist at the time) antibiotics, which not only didn't do anything to fix the dental massacre but then sent my health spiralling out of control over the course of several months, losing half my bodyweight in the process and nearly dying. It was only after I recovered (which involved being hospitalised) that I searched long and hard to track back to what the trigger had been, because I sure as heck never wanted to go there again. And it all started with those antibiotics. So I'm afraid I'm not a fan. Which means I'm going to try really hard to sit on my hands and not snark during this blog, although I may not be able to help myself, so try to forgive an aging post-menopausal old thing. And following that particular opening para, all I want to say is No sh** Sherlock. Moving on ...

Their research revealed that people who had taken a single 1 or 2-week course of antibiotic tablets within the previous 12-months (my two rounds of antibiotics were 2 x 2-weeks' worth, one straight after the other, because the first round hadn't worked), were 70% more likely to develop sepsis than those who didn’t use them at all. And no surprise, this risk increased with the number of times a person used antibiotics.

Dr Colin Brown, head of antimicrobial resistance and sepsis at UKHSA, and one of the PhD co-authors of the study, said “This may be due to underlying differences in their immune status or conditions that predispose them to repeat infections.”

Apparently there are around 250,000 (human) cases of sepsis every year in Britain, with around 50,000 dying from the infection - more than bowel, breast and prostate cancer combined. Just a simple minor cut or chest infection can trigger it, but it’s hard to diagnose because (what’s left of) the body’s immune system overreacts to the threat and begins attacking its own tissues and organs (because the immune system is so wrecked that it can no longer cope, so the body’s now in a state of autoimmune syndrome). Cue emergency intervention, usually involving more antibiotics, otherwise we could be looking at multiple organ failure and death.

And no surprise, since the pandemic there’s been a huge surge in antibiotic prescriptions and resistant infections, with our GPs doling out antibiotics like sweets. Shocking numbers show that in 2022 alone, one million of us were taking an antibiotic on any given day.

It’s now got so bad that Dame Jenny Harries, CEO of the UK Health Security Agency (UKHSA), has called on us – the public - to “treat antibiotics with respect”. (Really sitting on my hands here ...)

The simple truth is that antibiotics destroy the body’s immunity - they indiscriminately kill the gut bacteria, both good and bad. A single course of antibiotics will permanently change an immune system, especially that of a youngster (horse or human), and because a majority of neurochemicals are also made in the gut – serotonin for one, the body’s neurology is also altered. What was once heralded as the saviour of all disease is now costing us in degenerative, chronic diseases. 
 
When antibiotics are administered, the immune system’s ability to manufacture new immune cells is permanently altered. The unfriendly bacteria in the gut is now unobstructed and begins to proliferate, unchecked by the now diminished friendly bacteria. Parasites and pathogens now move in to share the nutrients meant to feed the body. This is the first step for chronic disease, and from here on in, every-thing changes.
 
Sadly this isn’t new news either – the medical industry as a whole has known for yonks that antibiotics don’t work anymore. The bugs out there are now so resistant to antibiotics that the term ‘superbug’ is now a household name – think MRSA.

The inflammatory double-whammy 

Once the bad bacteria sets up shop, the intestinal wall becomes leaky, allowing partially digested, putrefactive toxic foodstuffs and dead bacteria to cross through into the blood. The already weakened immune system now has twice the work to perform, trying to clean up the gut while urgently tracking down these new threats to the body.
 
And so begins an inflammatory response. The leakage of particles into the blood crossing the now compromised gut barrier, causes inflammation throughout the body – one of the main triggers of  laminitis. Chronic digestive and immunity stress weakens the major detoxification organs (liver, kidneys, lymph nodes), which prevents them from functioning properly, and so makes the body more susceptible to disease and toxin overload. It’s worse still if we’re feeding our horses chemically-treated, refined, artificial, processed and sugary junk from those shiny bags that their gut hasn't evolved to eat anyway. 
 

So is the post-antibiotic era on our doorstep?

We know that drug-resistant bacteria is nothing new, just like the majority of worms and parasites that are now resistant to chemical wormers. The pathogens are continually adapting and developing resistance to the very substances originally designed to kill them, yet there are simply not enough new antibiotics being developed to tackle all these new and virulent superbugs. Bacteria is now outsmarting the best that modern medicine has to offer.
 
And horrors, but no secret - one of main reasons responsible for antibiotic resistance is the widespread use of antibiotics in factory farm animals, which apparently accounts for a staggering 80%-plus (!!!) of antibiotic use. Administering antibiotics to perfectly healthy livestock for the purpose of bulking them up faster - which for the record is a practice that has been taking place since the 1950s - represents just one of the many ways in which antibiotics have been widely overprescribed.

The poultry industry specifically is renowned for administering growth hormone to their stock 🤢, which we then consume when we sit down for our Sunday roast. Yet another reason to avoid factory-farmed and buy organic instead. Is it any wonder that we’re now staring down the barrel at a superbug epidemic?
 
To quote Alexander Fleming (the creator of penicillin), back in 1945 when he received his Nobel Prize for medicine: "It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them. There is the danger that the ignorant man may easily underdose himself, and by exposing his microbes to non-lethal quantities of the drug, makes them resistant.”
 
Once upon a time the solution was simple - develop new, safer, and more effective antibiotics to replace the old ones. However, this approach is no longer working, and is further exacerbated by the drug industry's actual refusal to develop new antibiotics, because . . . they’re not nearly as profitable as other areas of drug research. (Really sitting on my hands not to type what I think of that … Sorry, cant’ help myself. That dirty ‘profit’ word again - keep ‘em sick, keep us rich.)
 
And many vets are in on it as well, chucking antibiotics at us for our horses for the most irrelevant of issues. Bonkers. Back in lockdown our MacAttack had a swollen sheath due to a bean which needed removing, and afterwards the vet gave me antibiotics which needless to say I didn't give to our little chap. I also still shudder at the memory of Carmen when she came to live with us back in 2014, where I inherited a nasty wound on her RH fetlock which blew up a week or so afterwards. Joint sepsis, I was told. Bute and antibiotics (of course) and if not improved within 3-days it was PTS. No ifs, no buts – her life was over. At just 7 years old.

Then the vet told me that the antibiotics only had a 5% chance of working anyway. Seriously? Just 5 measly percent? Was I really putting all my hopes of her recovery - her survival, on just a pathetic 5% chance? As the vet left, her final farewell comment was something along the lines of us speaking in a couple of days to set up the appointment of death.
 
Needless to say, as before with our Kelso, my desperate emotions turned to fire-breathing anger. Cue a blend of nature’s finest antimicrobials (what became our BioCARE), and Carms abscessed beautifully 2-days later through her coronet band. She limped out of her stable back to her field without looking back. Needless to say I didn’t make that follow-up call, and I'm pleased to say she’s happily still with us today, now aged 17 and thriving.

Then there was a recent client’s email which struck at one of many thorns in my side. The issue? Scabby eruptions on the horse’s back. “Vet was consulted and prescribed antibiotics, these did not work, so after calling him out again he examined her and said it was possibly sweat.” 
 
Altogether now - raise those eyebrows. This was clearly a simple case of toxin overload being excreted via the skin. And yet the vet went straight in with antibiotics, whereby the owner had to fork out not only for a costly script for a hefty measure of inappropriate gut-damaging chemicals into their horse's already compromised system, which also put huge extra strain on their liver and weakened their immunity even more, but she had to pay for a 2nd call-out to boot. And to add further insult to a world of pain in her bank account, the antibiotics didn’t bluddy work anyway.
 
And another just last week. A client’s horse got a hind hoof abscess back in June. Quote - “Came back again quite soon after once she started work again (been barefoot most of her life and always had great feet). Has recurred a couple more times. Vet prescribed antibiotics and box rest (which she hates).” Hang on ... Box rest? For an abscess?

I replied back asking if she was brave enough to stop the anti-b’s immediately, but it was too late – she’d already finished the course. Her reply - “The antibiotics are finished and surprisingly didn’t work.”

Okay. And b-r-e-a-t-h-e … because ...

What if there’s no choice though?

We need to put some balance in here, and I need to stop feeling snarky. Of course it’s vital to avoid unnecessary antibiotic use, but what about those cases where there really is no choice? Is there any hope for recovering the gut microbiome? The good news is that there is hope – it'll take some time and effort, but there are a few useful tips to follow both before, during and after a course of antibiotics, to lessen the damage and encourage regrowth and diversification of the gut biome.

Prebiotics
Not probiotics but prebiotics, which are much more effective at promoting the growth of the beneficial bacteria in the hindgut. Agreed, there’s not much research in the use of probiotics specific to the equine gut, and the fact is that science is still learning about the human gut microbiome. However, what the human studies are currently showing is that adding just a few species of a small quantity of bacteria inside the gut … well, it just doesn’t cut the mustard.

Far better to look to prebiotics, as they’re the food that feed the live, friendly bacteria, so keeping them fed and happy is the only effective way of promoting the growth of their colonies. No doubt about it - prebiotics are an incredibly important part of any regimen to protect and rebuild a healthy micro-organism community.

What’s also known to help are phytonutrients, which you'll find in abundance in our old friends, herbs 😉. For starters they're jammed with awesome antioxidants, and there are so many to choose from – turmeric, andrographis, garlic … plus what we know as the ‘oily herbs’, all thought to suppress pathogens and yeast overgrowth in the gut, which once out of the way gives the friendly microbe colonies a chance to repopulate.

The thinking now is we should be focusing on promoting the growth of the hindgut cellulose fibre-fermenting microbes in the hindgut, and not chucking in a spoonful of a few bacteria species that aren’t known for definite to be recognised friendly members of the equine gut biome. And the only source of cellulose comes from stemmy hay, which is rich in cellulose/hemi-cellulose fibre. Gentle reminder though - if you're soaking your hay for a long time, make sure you rinse and repeat repeatedly, as that soaking liquor becomes a toxic bacterial soup which the horse will then ingest as they’re chowing down on their soaked hay.

It should also always be about diversity of the grass forage species our horses eat, because it’s all about enrichment of that species-appropriate forage fibre (cellulose); different grasses have different prebiotics, just like we have a whole different range of salad leaves on our plate – they may just be salad leaves, but they each have their own different nutritional superpowers 😉. And don’t forget important roughage either – barks, leaves, and roots, all passing through the equine hindgut and with their own benefits.

Gut and liver support
When antibiotics throw the gut biome into turmoil, the gut lining and digestive function as a whole take a hit too. This is where ginger can be extremely helpful in reducing inflammation and calming the digestive system, and horses generally enjoy ginger. It’s always best to use fresh, fine-chopped ginger, or you could make a ginger tea by infusing it in hot water for a minimum 20-mins, then use it as your feedbowl soak. Ginger will not only boost a horse’s immune system and support the gut, but it also helps with mobility & respiratory function.

Top ginger tip though - ginger's main energetic is 'hot', so if there's existing inflammation elsewhere in the body, i.e. a lame leg, then it's best avoided.

Antibiotics will also take one heck of a toll on the liver, particularly if a horse is on them for a long time. To quote Charlotte Gerson of the Gerson Institute, “All pharma meds are damaging to the liver bar none.”

Not only is the liver responsible for processing and biotransforming those pharma meds, but it also has to deal with all the extra circulating toxins from the increased bacterial death and intestinal permeability (leaky gut). Milk thistle is a given here – it’s said to have no pharmaceutical equivalent when it comes to liver support. Alternatively, see our LiverCARE blend.

To conclude

So there we have it – i know, a bit of the same-old same-old from me, but whether human or horse it’s always about the right diet, supported by nutrients, herbs, and equine-appropriate prebiotics (diverse cellulose fibre), adding valuable natural roughage diversity into our horse's diet to restore and maintain a healthy gut biome.

It should never be just about profit – for sure, a business needs to make a profit but not at the expense of the buyer. We all have the absolute right to be concerned when it comes to our horses suffering the consequences, especially when the doctors and vets are getting a free lunch and a handshake because they’re allianced to a particular pharma company. This just makes it so wrong. I’d like to think that there are many disappointed vets as well - a lazy vet who blithely writes inappropriate and pointless scripts, to keep their fat commissions rolling in, potentially risks the whole veterinary profession’s reputation, and there’s already a catalogue of material out there for that.
 
Our vet should be worth their weight in gold. God forbid we could be heading to a point where we're having to decide whether we submit our horses to any medical treatment or procedure. Are we entering a new arena – having to make decisions that we would never have had to make previously?

There’s a massive message in all of this, and you don’t need me to spell it out. In the meantime, as far as the future of antibiotics are concerned, who only knows?
 
Sorry this was all a bit doom and gloom, but I promise to see you on the other side with my next Blog full of smiley cheer 😁. I mean, we're just 3-days away from 1st December (December newsletter out soon), the Christmas Lights are up on our high street, and last night as I drove home someone had already put up their twinkly Christmas tree in their front window.  What's not to love?!

Sources:

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00498-4/fulltext

https://www.manchester.ac.uk/discover/news/study-links-deprivation-with-risk-of-dying-from-sepsis/