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Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues Hardcover – 8 Apr 2014

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“The weight of evidence behind Dr. Blaser's cautions about antibiotics is overwhelming.” ―The New York Times

“Unlike some books on medicine and microbes, Dr. Blaser's doesn't stir up fears of exotic diseases or pandemic 'superbugs' resistant to all known drugs. He focuses on a simpler but more profound concern: the damage that modern life inflicts on the vast number of microbes that all of us, even healthy people, carry inside us at all times.” ―The Wall Street Journal

Missing Microbes presents a surprisingly clear perspective on a complex problem.” ―Philadelphia Inquirer

“In Missing Microbes, Martin Blaser sounds [an] alarm. He patiently and thoroughly builds a compelling case that the threat of antibiotic overuse goes far beyond resistant infections.” ―Nature

“Readable and challenging, Missing Microbes provides a stimulus with which to probe existing dogma.” ―Science

“Blaser presents a sensible plan for reclaiming our microbial balance and avoiding calamity both as a society...and on an individual level.” ―Discover

Missing Microbes blazes a new trail.” ―The Huffington Post

“An engrossing examination of the relatively unheralded yet dominant form of life on Earth.” ―Publishers Weekly (starred review)

“Blaser's Missing Microbes is a masterful work of preventative health and superb science writing.” ―Booklist (starred review)

“Credit Blaser for displaying the wonders and importance of a vast underworld we are jeopardizing but cannot live without.” ―Kirkus

“Missing Microbes adds a new frontier towards understanding vastly underappreciated key contributions of the human microbiome to health and human disease. As a world leader in defining the microbiome, Dr. Blaser explains how disturbing its natural balance is affecting common conditions such as obesity and diabetes, long thought of as primarily nutrition and lifestyle related problems. Blaser's carefully and convincingly written book outlines new dimensions that need to be considered in fighting a number of common diseases and in promoting health and well-being.” ―Richard Deckelbaum, Director, Institute of Human Nutrition, Columbia University

“In a world that turns to antibiotics for every infection of the ear, sinuses, or skin, Dr. Blaser makes even the most nervous parent think twice about giving her child these ubiquitous drugs. Dr. Blaser contends that the excessive use of antibiotics--especially in children--is at the root of our most serious emerging modern maladies, from asthma and food allergies to obesity and certain cancers. He walks us through the science behind his theories and examines the duality of microbes, both as essential agents of good health and perpetrators of sickness. At a time when the Centers for Disease Control and Prevention is campaigning for more judicious use of antibiotics, Dr. Blaser delivers a thoughtful, well-written and compelling case for why doctors need to be more cautious about prescribing these medications and why consumers should consider alternatives before taking them.” ―Nirav R. Shah, MD, MPH, Commissioner of Health, New York

“Dr. Blaser's credibility as a world class scientist and physician makes this exploration of our body's microbial world particularly provocative. Missing Microbes will make you rethink some fundamental ideas about infection. Blaser's gift is to write clearly and to take the reader on a fascinating journey through the paradoxes and insights about the teeming world within us.” ―Abraham Verghese MD, author of Cutting for Stone

“I have often wondered why kids today seem to have such a high incidence of asthma, ear infections, allergies, reflux esophagitis and so many other conditions that I rarely saw growing up. This mystery has been solved by the pioneering work of Dr. Marty Blaser and is communicated brilliantly in Missing Microbes. I cannot emphasize enough the importance of this book to your own health, the health of your children and grandchildren and to the health of our country. Missing Microbes is truly a must read.” ―Arthur Agatston, author of The South Beach Diet

“We live today in a world of modern plagues, defined by the alarming rise of asthma, diabetes, obesity, food allergies, and metabolic disorders. This is no accident, argues Dr. Blaser, the renowned medical researcher: the common link being the destruction of vital bacteria through the overuse of broad-spectrum antibiotics. Missing Microbes is science writing at its very best--crisply argued and beautifully written, with stunning insights about the human microbiome and workable solutions to an urgent global crisis.” ―David M. Oshinsky, author of the Pulitzer Prize-winning Polio: An American Story

“Why is it that you are fat, your son has asthma, and your 13-year-old daughter is six feet tall? Dr. Blaser says your bodies are missing vital, beneficial bacteria and I guarantee that after reading this book you will agree. Take a pass on the antibiotics and read Missing Microbes.” ―Laurie Garrett, Pulitzer Prize winning writer and Senior Fellow for Global Health at the Council on Foreign Relations

About the Author

Dr. Martin Blaser has studied the role of bacteria in human disease for over 30 years. He is the director of the Human Microbiome Program at NYU. He founded the Bellevue Literary Review and has been written about in newspapers including The New Yorker, Nature, The New York Times, The Washington Post, and The Wall Street Journal. His more than 100 media appearances include The Today Show, GMA, NPR, the BBC, The O'Reilly Factor, and CNN. He lives in New York City.

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Amazon.com: 4.7 out of 5 stars 236 reviews
98 of 105 people found the following review helpful
5.0 out of 5 stars Startling New Information About Overuse of Antibiotics 29 January 2014
By Frederick S. Goethel - Published on Amazon.com
Format: Hardcover Vine Customer Review of Free Product ( What's this? )
As most of us know, the medical community has been over prescribing antibiotics for some time now, and there is a call for the practice to end. There is no need for the use of antibiotics in many cases, and the use of them could be curtailed significantly without harm to public health. In addition, the author of this book presents compelling evidence that the overuse of antibiotics is not just causing resistance in microbes, but may also be contributing to the alarming increase in a number of diseases.

The book begins with several chapters that explain microbiology and how microbes are aligned with the human body. For instance, there are millions of microbes living in your intestinal tract, but they are not harmful; in fact they may be very beneficial. Early and frequent use of antibiotics can disrupt this natural ecosystem causing a myriad of problems.

There is also information on how we obtain our microbiological flora. For instance, microbes are passed from a mother to a baby during birth. As the baby exits the birth canal, it is coated in the naturally occurring bacteria that is found there normally. In addition, the newborn will pick up bacteria from nursing and from being handled by the mother. All of this is normal, and healthy, but overuse of antibiotics maybe causing disruption of the normal process.

In information presented that was startling, the author has linked a bacteria found in the stomach, and thought to cause ulcers, to an increase in the number of cases of gastrointestinal esophageal reflux disease. When it was first proven that the bacteria in question was responsible for ulcers, doctors went on a spree to eradicate it from adults. What followed was a large increase in the number of cases of GERD, in which gastric acid backs up into the esophagus and thereby damages it. In addition, the eradication of that bacteria may lead to it being eradicated from infants, which is a possible cause for the increase in asthma cases being seen in children.

The author also presents evidence of obesity being linked, quite significantly, to the use of antibiotics in the food supply and in early childhood. It is an interesting correlation, and may provide the answer to why there has been such a large increase in the number of obese children.

These are only some of the evidence presented and I am oversimplifying the information because of the brevity of a review. The information is fascinating, and may unlock the secrets to a number of "new plagues" as the author describes these diseases.

The book is very well written and is written with the lay person in mind. I had no problem following the science presented in the book and found the reading to be interesting and compelling. This is a must read for anyone concerned about health and the path we need to be on to correct our problems. Highly recommended!
48 of 51 people found the following review helpful
5.0 out of 5 stars Powerful (and slightly scary) Ideas 20 February 2014
By Burgundy Damsel - Published on Amazon.com
Format: Hardcover Vine Customer Review of Free Product ( What's this? )
Antibiotics changed the face of medicine and have been responsible for saving untold lives. It's never been a secret that they tend to indiscriminately wipe out bacteria in our bodies, killing the good with the bad, or that antibiotic use has been rising dramatically for decades. Yet only recently that scientists have begun to piece together a real understanding of the grave, long term consequences that has on our bodies.

Scientist and author Martin Blaser does an excellent job of helping readers navigate the complex world of genomes, biomes, bacteria, viruses, and their complicated interactions and impacts on human health. He simplifies the material enough that it can be easily followed by a lay person while keeping it firmly rooted in solid science, research, and medicine. Shocking facts are sprinkled throughout (your average American gets more than 17 courses of antibiotics by age 20), but they are never used for shock value - merely reported in an honest, factual nature that keeps with the serious, professional tone of the book.

Blaser explores the long term consequences of heavy antibiotic use on individuals and society, and draws clear (and disturbing) links between overuse of antibiotics and modern plagues including diabetes, obesity, IBS/ulcerative colitis, asthma, and escalating food allergies. Using decades of sound scientific research and examples from both modern life and the history of medicine, he offers a slightly frightening but completely realistic picture of where we are headed as a planet if we don't change our ways. The book outlines key problems, offers viable (but not easy) solutions, and calls on all of us as a society to make better choices while we still can.

The book was a little on the dry side, but clearly written by a man passionate about his subject and it provides significant food for thought. An excellent read, and one we all do well to pay attention to!
17 of 17 people found the following review helpful
4.0 out of 5 stars A necessary and well written book but don't look for immediate answers here 11 September 2014
By Liat2768 - Published on Amazon.com
Format: Hardcover
The Medical community is slowly but surely coming to recognize the importance of gut flora and the epidemic proportions of the issues caused by the overprescription of antibiotics today. For someone unaware of the issues this book is an eye opener. The discussions of the individual flora that modern medicine has sought to eradicate (E.G H Pylori)and the link to various diseases that cropped up in individuals missing certain flora are clear and well explained. The issues caused by C-Sections and rampant antibiotic use in infancy are also explored.

The reason for my rating only having four stars is that there are very few suggestions for what we, as individuals, can do now that we are in the midst of the issue. I've had the H-Pylori treatment. My children were on multiple rounds of antibiotics before age two. One has celiac disease and is on the Spectrum. If, as this book shows, antibiotic use may have contributed to or triggered many of the health issues we have then I would like to know what I can do about it.

The last chapter in this book is titled 'Solutions' but there are not so many of those that an average parent can employ. Probiotics and prebiotics are compared to placebos (granted some of them ARE pure rubbish), and the suggestions given involve reduced prescription of antibiotics, reduced use of antibiotics in animal husbandry, reduced use of hand sanitizers, less C-sections and, most radically, fecal transfer. This is all well and good but what are parents who are aware of the problem to do now? I've tried to eliminate all the contaminants I can but know well that there is a very good chance one of my children would not have survived if not for the powerful antibiotics he was treated with as a child. As I type this review I have my child on antibiotics for a bad case of Strep. What next?? If yogurt, probiotics and prebiotics aren't going to help then do I just sit and wait for the medical community and the FDA to play catch up and come up with a solution while chronic diseases are triggered in my children's bodies?

I'm afraid I found this book frustrating in the extreme. As a wake up call to fellow practitioners it has value. For someone looking for a solution to a problem they are already aware of, there is no reassurance, no suggestions and no help here.
36 of 42 people found the following review helpful
4.0 out of 5 stars Missing Microbes 20 March 2014
By M. Reynard - Published on Amazon.com
Format: Hardcover Vine Customer Review of Free Product ( What's this? )
I am not a doctor, nurse, scientist, really any type of person in the medical field. I'm just a person who thinks that reading about medical issues is interesting. So it's important for you to know that I'm going into this review without a lot of background and understanding of microbes and biology. There, the disclaimer is over with.

Missing Microbes is about the microbes in your body and the use of antibiotics. It explores the concept that perhaps we are doing ourselves a disservice by using so many antibiotics and that some of the microbes previously thought harmful, are in fact an integral part of our body's system and essential to our well being. Especially explored is H. Pylori that resides in your digestive system and is thought to be a contributor to stomach cancer and ulcers. Previously eradicated when it was found, new research is showing that it helps protect against other ailments and the destruction of it with antibiotics may not be the best course of action. There is also a section on birth and the impact that caesarian sections has on the passing of natural microbes from mother to infant. And several other facts about the bacteria in our bodies.

You can definitely tell the author wanted you to know what he's contributed to the field. And there's nothing wrong with that although it is a little distracting. Most of the focus is on the research and several studies are described. I appreciated the fact that it was written in language that I could understand. While there were some medical concepts that were a little harder for me, by and large, I understood the descriptions and theories that were presented in this book. I imagine someone in the medical field would understand it a lot better than I though as they are already comfortable with the terminology and different theories being presented. I also appreciated that the chapters flowed together smoothly and that while new concepts were introduced in each one, there was a transition that helped guide from talking about one topic to the next.

I learned a lot from this book. For instance, I never realized that antibiotics are given to farm animals to make them gain weight. I always figured it was because disease was rampant when you pack animals in together so tight. The experiments performed on mice showing how antibiotics caused gain of both fat and muscle in early "childhood" was an interesting concept when thinking about the obesity epidemic that the United States and many other countries are facing right now. However, as said before, I am not a scientist and cannot comment as to the validity of any of these experiments, although it seems (judging from the quite large notes section in the back) that the author did the research and in fact had performed many of the experiments himself. I believe it's best to look at your information from all sides though and not to take anything from any one paper or book as the absolute truth.

This book does present some compelling arguments about the use of antibiotics. Even if you're not worried about super-bugs from overuse, there are several other factors that have only started to be researched. Anyone interested in bacteria, microbes, and the use of modern medicine would probably find this book a good read.

Missing Microbes
Copyright 2014
259 pages

Review by M. Reynard 2014
16 of 18 people found the following review helpful
5.0 out of 5 stars 90% Of Your DNA is Microbial And It Isn't Happy 5 April 2014
By Herblady22 - Published on Amazon.com
Format: Hardcover Vine Customer Review of Free Product ( What's this? )
I have been blogging on the ecology of the human microbiome for some time, so I wasn't sure whether it would be worthwhile to read this book when I saw it on the Amazon Vine booklist. Boy am I glad that I did! I learned quite a lot, yet the book is readable enough for a layperson. Blaser, a world-class scientist, made his mark studying H. Pylori soon after it was implicated in causing ulcers, then later gastritis and stomach cancer. However he realized after eliminating his own H. pylori that he started suffering from GERD, which is implicated in its own cancers and erosion of the esophagus. He later tied missing H. pylori, which used to be ubiquitous, to asthma and other diseases, especially in children.

While I have considered our beneficial gut, mouth and skin bacteria to be symbionts ("living with") or commensual ("eating at the same table"), Blaser makes the case that at least some bacteria are good in some situations and bad in others or in overgrowth. Lactobacilli from yogurt may be good for our guts, but are too acid for our teeth. E. Coli is mostly benign and even qualifies in Europe as a probiotic that may help keep you thin, but some variants and high concentrations can give you diarrhea. Blaser uses the term "amphibionts" which better expresses the complicated, sometimes beneficial, sometimes detrimental and sometimes neutral relationship between us and our microbiota.

The most interesting part of the book for me was the chapter on mother and child. During pregnancy the balance of the vaginal (and other) ecology changes to protect the mother's immune system, to better extract caloric value from food as the fetus grows (hence third semester gestational diabetes in women with imbalances) and to inoculate the baby's immune system and ability to use breastmilk as it passes through the vagina. This does not happen during a C-section and the balance of bacteria is more like hospital sheets than that of the mother. Some have suggested seeding the skin and mouth of a baby born by C-section with vaginal bacteria so that the balance will reflect the pattern created over millions of years.

Antibiotic use has significantly eliminated bacteria that we need to keep our immune systems functioning. Not only are antibiotics overused clinically but they are vastly used in agriculture to the point that most meats sold in the US are contaminated with fecal bacteria and sometimes even MRSA, the antibiotic resistant Staph aureus. The antibiotics are sold to fatten up animals used for food- it is due to an interaction between animal gut bacteria and the drug- and direct and indirect antibiotic abuse may be responsible for our obesity epidemic.

We are fast losing the ability to save lives with antibiotics because of bacterial resistance. Bacteria possess sophisticated methods to adapt and mutate when attacked, and bacteria from archeological sites indicate that ability long preceded antibiotics, although penicillin bread molds were used by the ancient Chinese, Egyptians and Central American Indians. Fast travel, which inhibits the ability of the microbiota to change to meet new challenges, and pharmaceutical challenges leave us more vulnerable to modern day plagues.

I have seen patients who developed oxalic acid kidney stones or "glass shard" vulvodynia after antibiotic and pharmaceutical use destroyed their Oxalobacter forminges bacteria. I have seen hospitals give more potent antibiotics to wipe out MRSA when botanicals or essential oils have been found in research to work as well. C.diff infections respond over 90% of the time to fecal transplants from a clean donor but are routinely treated with increasing dosages of ineffective but detrimental antibiotics. Antibiotic abuse hurts good bacteria along with bad and 90% of our DNA is microbial. We are walking superstructures of microbes and health is about regulating our ecology. and antibiotic use should be rare if we want to preserve it.

I highly recommend reading this book. It is basic education for parents, medical professionals and anyone who gets sick.