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Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues

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A critically important and startling look at the harmful effects of overusing antibiotics, from the field's leading expert

Tracing one scientist’s journey toward understanding the crucial importance of the microbiome, this revolutionary book will take readers to the forefront of trail-blazing research while revealing the damage that overuse of antibiotics is doing to our contributing to the rise of obesity, asthma, diabetes, and certain forms of cancer. In Missing Microbes, Dr. Martin Blaser invites us into the wilds of the human microbiome where for hundreds of thousands of years bacterial and human cells have existed in a peaceful symbiosis that is responsible for the health and equilibrium of our body. Now, this invisible eden is being irrevocably damaged by some of our most revered medical advances—antibiotics—threatening the extinction of our irreplaceable microbes with terrible health consequences. Taking us into both the lab and deep into the fields where these troubling effects can be witnessed firsthand, Blaser not only provides cutting edge evidence for the adverse effects of antibiotics, he tells us what we can do to avoid even more catastrophic health problems in the future.


289 pages, Kindle Edition

First published February 6, 2014

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About the author

Martin J. Blaser

23 books63 followers
Martin J. Blaser MD has studied the role of bacteria in human disease for more than thirty years. He is the director of the Human Microbiome Program at New York University, served as the chair of medicine at NYU and as the president of the Infectious Diseases Society of America, and has had major advisory roles at the U.S. National Institutes of Health. He co-founded the Bellevue Literary Review and his work has been written about in publications that include The New Yorker, Nature, The New York Times, The Economist, The Washington Post, and The Wall Street Journal. His more than one hundred media appearances include the BBC, CNN, NPR, The Today Show, Good Morning America, and The O’Reilly Factor. He lives in New York City.

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Displaying 1 - 30 of 431 reviews
Profile Image for Wanda Pedersen.
2,278 reviews360 followers
January 12, 2015
I've been doing a lot of research lately about the inner biome of the human being--all the micro-organisms which share space with us and help to keep us healthy. This book distills a great deal of that information into one coherent volume, which is great.

We have more bacterial cells in and on us than we have body cells. They help us with digestion, hormonal regulation, and immune responses. Without them, we would be hooped. Evidence is accumulating that the use of antibiotics has drastically changed our inner landscape, wiping out some friendly bacteria which help us to live a more healthy life--we can perhaps blame celiac disease, food allergies, and asthma on changes in our gut bacteria.

You know that an author is seriously devoted when he is excited that anthropologists have found a group of South American indigenous people who have never encountered Western medicine and is thrilled to get fecal samples from them! To see a natural intestinal fauna which antibiotics have never decimated.

Like many authors with a relentless focus, Blaser is on a bit of a soap box. Doctors have been giving out antibiotics "just in case" and considering that they do no harm. He discusses antibiotic resistant infections and the real danger that we will soon have no treatments that work on diseases that we thought we had under control.

I was hoping for advice on what the average person could do to cultivate their garden, so to speak, but didn't find many suggestions, besides not pressuring your doctor to give you a prescription for every cold or cough that presents itself. I've been taking a probiotic supplement, which Blaser says is probably not harmful, but no one has proven that the organisms in the supplements are helpful ones either.

But this is a hot area of research, so I plan to stay tuned!

Profile Image for Audrey.
Author 14 books116 followers
June 28, 2014
This book should be required reading for anyone in the medical profession, parents, and policy makers (especially in agriculture and drug regulation).

In a clear and non-technical way, Blaser--an MD and former head of the Infectious Diseases Society of America--lays out the chilling story of how the unintended consequences of antibiotic use and overuse may be in danger of destroying civilization. That might sound ridiculously overblown, but his case rests on sound science. He likens the changes happening internally to what we now call the "human microbiome" to the deterioration of the external environment under the assault of increasing CO2 levels.

I was particularly interested in the potential connection between obesity and early and frequent use of antibiotics in babies and children (and perhaps even prenatally, as mothers take antibiotics during labor). Blaser cites some very convincing animal studies. Though he is careful to say that the exact mechanism by which this may happen is not fully understood, he urges more research.

I, like Blaser, want to acknowledge the tremendous good antibiotics have done since their introduction a little less than a century ago. It's just that, as with all beneficial things, more is not necessarily better and it behooves us as individuals and as a society to understand the possible negative consequences of something that also does good. I'll say it again: everyone should read this book as an eye-opening view into the risks of a class of wonder drugs we once thought had only short-term, negligible side effects.
Profile Image for David Schwan.
1,149 reviews48 followers
May 9, 2014
An intriguing book. The author gives a broad overview of the microbes that live with all people and the effects of antibiotics on the the human microbiome. The author explains overuse of antibiotics--particularly in children and farm animals. Milk we buy in the grocery story can have measurable levels of Tetracycline and even though we may not think we are taking antibiotics we can be. The author explains the results found in many studies on mice, and the results of studies on humans showing how the overuse of antibiotics are causing a variety of diseases.

My only complaint is that the author inundates the reader with evidence, study after study where it seems the results are clear, yet overall many people in the same field are skeptical.

The author sends a strong message that new approaches need to be taken to both the diagnosis of infections (i.e. better methods to determine what infection if any we might have) and more emphasis of antibiotics that are targeted to individual strains as opposed to the broad spectrum solutions currently in use.
Profile Image for J.S..
Author 1 book68 followers
May 25, 2018
I had a biology teacher in high school who remarked that we, as Americans, think that if a little of something is good, a LOT must be better. (The remark was made in connection with how much we all wanted to fertilize the plants we were growing in his class.)

Antibiotics were truly a miracle when they were developed in the early 1900s. Drugs like sulfa and penicillin saved millions of lives, but it wasn't long before antibiotics were being overused for everything from "just in case" to fattening-up the animals that end up on our dinner tables. I think many people are now aware of the rapidly growing potential for "super-bug" germs that are immune to antibiotics (which is already becoming a reality) and the need to back off the hand-sanitizer habit, but few know of the cost to our inner biome.

Say what? Inside our bodies we carry a LOT of bacteria - our biome. But before you freak out, just know that the overwhelming majority of them are harmless and many are probably not only beneficial but essential to good health. Wipe out those bacteria and you may be compromising your health. Children are especially vulnerable, and simply letting them have pets or eat a little dirt once in a while won't correct the situation. And the list of possible maladies that Dr. Blaser presents is mind boggling. Not only do we have to worry about infections like MRSA and C. diff, we also have increasing outbreaks of Salmonella, E. coli, and influenza. Plus Blaser suggests that changes in the bacterial component inside our bodies may be causing the obesity epidemic, some cancers, celiac disease, asthma and food allergies, juvenile diabetes, and maybe even autism. (His theorized connection to autism isn't to be confused with the disproved link to vaccinations.) On the plus side, he thinks it may also be responsible for making people taller.

Blaser isn't against using antibiotics, but rather a more judicious use of them - and currently we're using *way* too much of them. (He *is* very much against unnecessary c-sections, and yes it has to do with bacteria.) Some of his theories are based on somewhat tenuous evidence (he admits as much about autism), but his warnings are worth considering and it's a very scary scenario he paints. (In some ways this book is far more frightening than The Hot Zone: The Terrifying True Story of the Origins of the Ebola Virus or Scourge: The Once and Future Threat of Smallpox.) It had me wishing I had questioned my doctor further before accepting a recent prescription! My initial interest in the book leaned more toward how to improve the microbes in our bodies (which was touched on in The Hidden Half of Nature: The Microbial Roots of Life and Health), and he only briefly mentions pro- and prebiotics, and fecal transplants (yes, it sounds revolting, but... what if it could make you thin?). This was a great read, and easily understood even without a medical background.
Profile Image for Jenn.
111 reviews9 followers
May 10, 2014
WOW. This book was SO right up my alley but is not for every reader (I got a lot of "you're reading what??" Personal stories interwoven with sound science - absolutely fascinating and gives sound hypotheses for why we're seeing the modern plagues in today's society. If you've ever wondered why diabetes, allergies and other autoimmune disorder rates are rising so rapidly and want to go beyond the popular "hygiene hypothesis" I recommend this read! I wish I could start my children's first three years all over again; I will think about this every time we're sick and I'm faced with the choice of antibiotics. I recommend this to anyone interested in science and personal health.
Profile Image for Donna.
4,523 reviews156 followers
March 20, 2016
I recently read another book about this exact same topic.....Microbes. I liked that one, and I liked this one too. This was written in terms that ordinary people without a biology major or an MD after their name can understand.

This topic is thought provoking because it sheds light on things that have been taken for granted regarding present day and future medical care and the new health threats that seem to be popping up. This type of research on microbes is new, and hopefully it will continue to be explored and researched. This book dealt a lot with the overuse of antibiotics and its effects on our health. It definitely provided food for thought.
Profile Image for Diego Lovegood.
378 reviews107 followers
April 14, 2023
Increíble la evidencia y también su capacidad de imaginar. Un libro que habla de las consecuencias negativas del sobreuso de antibióticos en nuestra salud. Y ojo: no habla solamente de las resistencias a las bacterias sino también de cómo el abuso de antibióticos en la infancia ha provocado el aumento de alergias, asmas, obesidad e incluso el TEA. Todo por el daño que provocan a nuestro microbioma.
Profile Image for Emily.
687 reviews686 followers
June 2, 2014
I picked this up because I was actually a subject in one of Dr. Blaser's experiments a few years back when I worked at NYU--the study was about the microbiome of people who do or don't have eczema and I was a control subject, which required me to walk downstairs to his lab every few months and have a grad student swab my elbow, cheek, and knee.

The book was worthwhile but I wish Blaser had put more effort into explaining the science at a deeper level. While he avoids the faux-peppy style I've complained about before, he explains binomial nomenclature and other topics that you'd think any adult bothering to pick up a book like this would understand. The "how" in "How the overuse of antibiotics is fueling our modern plagues" means "I'm going to assert that" instead of "I'm going to explain in detail the means by which."

To backtrack a little, here's Blaser's thesis in a nutshell. Humans are covered with zillions of bacteria that live in different mixtures in different parts of the body, like the skin, intestine, or vagina. (Whenever I think of this, I picture Mr. Burns's Spruce Moose freakout on The Simpsons.) We are overusing antibiotics in a variety of contexts: using them in a knee-jerk way when they're not even needed for minor complaints; giving them to livestock to promote growth; giving them to children in a critical window of their development; using broad-spectrum antibiotics which are efficient to develop and sell rather than narrow-range ones that don't cause as much collateral damage to the microbiome. Antibiotics don't kill all the bacteria, but they change the environment so that helpful ones may lose out or destructive ones get a leg up. Blaser tries to show how this imbalance could be implicated in all sorts of modern conditions like asthma, obesity, etc.

The research is still in early stages, so he doesn't yet have a pill full of specific bacteria to fiddle with your natural population and knock out your allergies. Still, the book could change your behavior in terms of what kind of food you buy (do you pay extra for the no-antibiotics chicken?) and what you ask your doctor for (do you beg for antibiotics, or start questioning whether they're really needed?). Also, he is trying to raise awareness of antibiotic-resistant bacteria and the possibility of a fast-moving superplague we're not equipped to fight.

This was a fine read, but I could have walked, not run, to read it.
Profile Image for Bastian Greshake Tzovaras.
155 reviews91 followers
May 7, 2014
While I had to endure microbiology lectures and practical courses during my undergrad studies I never was too interested in it and just rote-learned the Krebs cycle as requested. I pretty much preferred living things that you can more easily observe on a macroscopic level and actually do stuff (i.e. animals. And the irony that I'm now exclusively working in silico, often without ever seeing 'my' organisms isn't lost on me…).

So I'm by no means an expert on any microbes and microbiomes, but by now I can see the appeal in working on those topics and Blaser does a good job in conveying his fascination with bacteria as far as I'm concerned. A lot of the book is about how the bacteria that colonize us are neither strict mutualistic nor parasitic/pathogenic symbionts, but live in a state of amphibiosis. Essentially living on a continuum between symbionts and pathogens, depending on external factors. Which I think is a pretty good view that one doesn't find too often from my experience. As one prime example Blaser focusses on Helicobacter pylori, the bacteria of Nobel fame that is primarily associated with ulcers, but Blaser argues at length (and not too bad) that H. pylori can indeed not only be a pathogen but also a pretty useful creature to have around.

Besides this Blaser devotes much of the book to describe how our obsession with keeping bacteria away from us, easily giving antibiotics and even using it for growth stimulation in livestock may be responsible for many of the ailments that have risen over the last couple of decades (asthma, allergies, diabetes, obesity, certain types of cancer etc.) due to a change in the microbial communities we carry with us. While his general arguments seem plausible I'm not sure how much of it is overselling the available evidence (and I couldn't be bothered to read primary literature tbh). But this blogpost by Jonathan Eisen gives at least some hints that this may be the case. Nevertheless, I think the argument for using less antibiotics, especially if the potential benefits of the usage are small, does hold.

Recommended: for anyone who wants some good reasons to abandon an overly antiseptic lifestyle.
Profile Image for Nicky.
4,138 reviews1,112 followers
August 22, 2016
Seeing the subtitle of this book, you might think it’s about the overuse of antibiotics which causes diseases immune to every method we have to treat them, especially the practice of giving antibiotics “just in case” and feeding antibiotics to animals (which actually helps them grow faster). In fact, while he does bring those issues up, Blaser is also concerned about an unforeseen effect of antibiotics: they’re killing “good” bacteria, with which we’ve co-evolved and which provide us with advantages (even if they aren’t always unmitigated advantages).

This is the sort of thing that’s really fascinating to me, even if I’m not sure I’m 100% comfortable with some of the things he refers to as “modern plagues” — especially not autism, because hey, I don’t think my friends with autism are “ill”. I think they just think differently, and society has the problem. In any case, Blaser does have some interesting research backing up his ideas, and the first half of the book does a very good job of explaining how we form our own personal microbiomes — and the catastrophic effects (viewed in the long term, as an average, not necessarily for a single person) of our modern health system, which actually destroys, undermines, or even prevents the formation of our microbiomes. Caesarian sections, for example.

I think Blaser’s theories might feel a little overstretched at times, but I don’t mind going along with the basic principle: we have these bacteria in our bodies for a reason, we tolerate them for a reason. We don’t really know the effects of what we’re losing, and the invisible advantages and protections it might offer. This much is definitely true, and also the fact that we’re overusing antibiotics as a kind of “better safe than sorry” — except it is going to make us very sorry, via antibiotic resistance alone.

I found this an enjoyable and pretty well-supported read, with the caveat of course that I’m only on the first year of my BSc and most of my knowledge comes from pop science and online courses.

Originally posted here.
Profile Image for Shaun.
Author 4 books220 followers
October 5, 2019
I love books like this.

Taken from the book jacket:

Martin Blaser "is the director of the Human Microbiome Program at NYU, served as the chair of medicine at NYU and as the president of the Infectious Diseases Society of America, and has had major advisory roles at the National Institutes of Health."

He has studied the bacterium H. pylori extensively. Linked to stomach ulcers, gastritis, and ultimately stomach cancer, this "stomach bug" is generally treated aggressively when found. Interestingly, Blaser and colleagues have established that while H. pylori can cause negative health outcomes in later life, it may also be protective against other diseases like asthma, esophageal adenocarcinoma, and possibly a whole host of other diseases earlier in life, a notion supported by research performed by Blaser and his cohorts. And, good or bad, it appears that H. pylori is slowly disappearing from the human microbiome.

Blaser's main point seems to be that humans have evolved as a complex ecosystem in which some inhabitants can be helpful at some turns and harmful at others. And thanks to relatively new changes like the invention of antibiotics, the increased incidence of C-section, and other changes to our environment, our microbiome may be undergoing a shift. It is possible, even likely, that this shift may be contributing to the increased incidence of diabetes, asthma, food allergies, and auto immune diseases...possibly others.

He acknowledges the importance of antibiotics, which save lives. Yet, he also points out that until now we did not know what the true cost of using them was/is. Assuming there was no downside to taking them, we may have been too indiscriminate and overly liberal when prescribing them, using them even if not absolutely necessary because we assumed they could only help and never hurt. But as we learn more about the role of microbes, whether they are good, bad, or possibly both, the more that assumption is looking to be false. In the end, like H. pylori, antibiotics could be both beneficial and harmful at the same time.

He also worries about antibiotics that are given to livestock, not to treat disease, but to fatten them up. He fears it will not only contribute to antibiotic resistant strains of harmful even deadly bacteria, but may also be exposing us to antibiotics indirectly through the foods we eat.

He also worries about the increasing prevalence of birth by C-section. It has been shown that babies born via C-section are missing certain microbes that appear critical for optimal health and development of the baby. And while the microbiomes of both groups eventually converge so that by age three there are no significant differences, the damage may already have been done. Again, he is not saying women should not have C-sections, just that we might not truly understand the long-term risks to the baby.

Bottom line: we are only now beginning to understand the immense impact the bugs living among us and even in us have. And as we learn more, we need to rethink standard practices to ensure that we aren't throwing out the baby with the bathwater, or worse, drowning the baby in the bathwater. We also need to take these bugs seriously and remember that they are older, and, at least from a evolutionary standpoint, wiser. They aren't simply going to go away. Good thing, too, since we need them probably more than they need us. And if we hope to avoid another massive plague thanks to a microscopic organism, we better start being smarter about how we use the antibiotics we currently have in addition to finding new ones. (He claims that the pharmaceutical companies have found many of the easy ones and aren't particularly motivated to find a cure for rogue bacteria like MRSA, simply because it isn't cost effective.)

Good book written with a lot of passion, yet not alarmist in its message.
Profile Image for Stephany (Goombah).
58 reviews
July 18, 2025
Fascinating read!

It definitely shifted my perspective on the vital importance of our microbiome as well as the care we should take not to disrupt it. The most shocking part were the many studies Dr Blaser conducted that demonstrated the damaging effects of antibiotics or especially exposing our young children and babies to them. 🤯
Profile Image for The Conspiracy is Capitalism.
378 reviews2,347 followers
January 16, 2019
Preamble:
--In studying standard of living, I see political economy as a core framework to study, on which numerous components interact: health, environment, agriculture, science/technology, culture, gender, etc. Each one of these has a compelling, nonlinear history. Here, we consider health.

The Good:
--As several reviewers note, the first half of the book summarizes our relationship with our microbial neighbors (i.e. Western history, current situation). Sadly, viruses and the history of vaccines are not included, as they are not classified as living organisms.
--The mass and rapid concentration of people from 18th century industrialization/urbanization brought a feeding frenzy for harmful microbes. As always, there are many more social factors to consider behind “economic growth”. Public health was the social response, and much progress was made regarding prevention. However, in terms of what happened when things went wrong (i.e. doctors/medicine), bloodletting lingered into the 20th century; for the magic pills, penicillin for public consumption occurred after WWII.
--A result of the evolving, anti-reductionist understanding of the natural world is the appreciation of microbes and how essential they are to life, from making up much of the human body, to their role in soil fertility (The Soil Will Save Us: How Scientists, Farmers, and Foodies Are Healing the Soil to Save the Planet). This book opens a can of worms microbes: what consequences have 70 years of mass antibiotics use had on our bodies' microbiomes (and their functions)? The doctor author hypothesizes that a loss in the diversity of our bodies' microbiomes (in particular: gut flora) is a factor in many modern ailments such as obesity and the numerous developmental and auto-immune disorders.
--2 particularly interesting ideas:
1) Obesity: corporate agriculture has been using low doses of antibiotics on livestock to increase animal body mass, thus profits. Does this translate in human exposure to antibiotics (medical, food, environmental)? Gut flora is, after all, crucial in metabolism.
2) Developmental/auto-immune disorders: a newborn is rapidly introduced to microbes involved in development and immune system functions. How does the rising rates of Caesarean sections (evading the microbes of vaginal delivery) and prophylaxis affect this crucial stage and future development?

The Questionable:
--The second half of the book is speculative, because most of this research is ongoing. I share a concern with other reviews that this may not be clearly distinguishable for general readers. More constructively, I think a chapter that overviews the principles of evidence-based medicine/research would be most helpful. A favorite: Bad Science
Profile Image for Nikki.
1,756 reviews84 followers
May 20, 2017
Summary of this book: H. pylori! Everything comes back to H. pylori!

The author of this book has to be one of the most myopic I have come across. He is absolutely obsessed with the idea that microbes are the cause and cure of everything. EVERYTHING. He also seems to struggle with basic science, like correlation does not necessarily mean causation. Having a hunch or suspicion is not the same as having proof. (Expect to hear these words a great deal throughout the book.) Most of the studies he references either have very small sample sizes or were performed on mice. Mice, you may know, are not actually humans. It tends to be a bad idea to rely on data from mice as most drugs found to work on mice and other nonhumans never make it to the market or end up being pulled from the market. In other words, mice and humans are not the same.

The author is also blind to major factors relating to obesity, diabetes etc., such as plastics, hormones in the environment, pesticides, herbicides, air and water pollutants, antibiotics in animal products and water and bioaccumulating in human bodies, stress, lifestyle and the differences between past and present. There are more factors than this but the author only sees microbes.

I do believe some issues are connected to microbes and that fixing our microbe imbalances is a good idea. However, they are not the be all and end all.

H. pylori!
Profile Image for Melissa.
429 reviews24 followers
January 5, 2017
Dr. Blaser's premise is that we are doing serious damage to our bodies by emphasizing the idea that all bacteria is bad and must be eradicated. He begins by giving the reader a background on how bacteria and humans evolved together. It was dense with science, but still understandable to the average reader. This sets the stage for the exploration of how bacteria, sometimes specific species or strains, work with our bodies to mention normal bodily functions. Modern chronic illnesses are discussed in relation to missing important bacteria, such as obesity, asthma, Type 1 diabetes, ulcers, irritable bowl syndrome and Crohn's disease, and throat cancer. Experiments are described and explained to further his argument.

Dr. Blaser does not condemn anyone; he is really trying to educate the public to re-think their use of hand sanitizers and asking for antibiotics from doctors for the slightest sniffle. Also, he shows evidence that America's high rate of C-sections may be a factor in why more children are diagnose with food allergies and hay fever. Therapies, treatments, and possibly cures may come from finding which bacteria is missing and re-introducing them into the human body. It was thought-provoking and interesting while still being scientifically useful for medical professions.
Profile Image for Michael.
1,070 reviews194 followers
May 14, 2015
An excellent analysis of the war between antibiotics and our microbiome. The material was very well-composed; as a microbiologist, I felt comfortable without being bored. I think that someone who isn't in the field would enjoy the book as well thanks to the author's concise explanations of historical and current practice. A cut above most of the pop-science books out there!
Profile Image for farah ♡.
156 reviews4 followers
August 21, 2021
3/5 Stars

An enjoyable read about current issues surrounding antibiotics (and how we use them). My favourite chapters would be about how giving birth essentially gives the newborn baby the microbiome he needed.

This book explained clearly why and how we should stop/reduce our antibiotics intake. From the overusing of antibiotics up to hygiene, we are slowly losing the ancient bacteria needed for our body to function properly. Hence, now we have modern plagues.

This may not be everybody's cup of tea, but it is definitely mine. A must read especially if you're really concerned about our antibiotics consumption.
Profile Image for Anshuman Swain.
242 reviews9 followers
February 3, 2025
4.5 rounded up to 5.

A very personal and detailed account of how antibiotics might be impacting human health and living. This book goes beyond the usual chat about antibiotic resistance and instead focuses on the importance of our microbiome. How using antibiotics shape these changes and how those changes impact our everyday lives: asthma, allergies, reduced immunity etc. Quite a wonderful read.
Profile Image for Atthea Jane.
15 reviews
August 24, 2020
Containing lots of helpful insights backed with scientific evidence. Highly suggesting this to those interested in science, health and medicine. 😁
Profile Image for maddie jeffery .
24 reviews
July 14, 2022
It was actually very interesting and informative and a little intimidating. I feel that all health care professionals should read it or at least know of the topic.
Profile Image for Joanna.
113 reviews9 followers
May 12, 2024
The book was an excellent look at the modern day tragedy of antibiotic overuse and its detrimental effect on human health. Having studied this topic as a layperson fairly extensively, most of the information was in line with both my research and my own intuition about the role antibiotics play in degrading human health. I was quite intrigued by the chapter on the microbiome’s link to increasing human height. Fascinating!

My only wish is that the author had posited more specific solutions to restoring missing microbes in individuals (vs. a generalized plan to halt the loss of microbial diversity). Seven years after a perfect storm of stress, pregnancy, and a course of cephalexin, my gut function still has not been restored despite many types of treatments and many thousands (tens of thousands, probably) of dollars. No one truly seems to know what the ideal human microbiome consists of AND how to propagate it in a human with a dysfunctional microbiome. If someone could really figure that whole piece out, it would be a huge boon to human health.
Profile Image for Erin.
4 reviews
May 17, 2024
Very well written, making this dense topic become a surprisingly easy read. References to research experiments and patient case studies were very interesting.
Profile Image for Dachokie.
379 reviews23 followers
February 13, 2014
Are We Ready for the Next Crisis?

This book was reviewed as part of Amazon's Vine program which included a free advance copy of the book.

The over-prescription of drugs isn’t exactly newsworthy … in fact, I’ll bet you can’t even watch a half-hour show on network television without at least one commercial dedicated to a drug that allows the suffering masses to better endure some miserable malady. Living in a world that promises a solution for every problem seems to have led to the “I-Med” path were currently on (“there’s a pill for that”). With his book, MISSING MICROBES, Dr. Martin Blaser explains how the unnecessary overuse of antibiotics (arguably the world’s most reliable and necessary medicine) may be leading to the onset of so many of modern society’s ailments: GERD/acid reflux, obesity, allergies/asthma, etc.

Blaser, a M.D. with 30 years of experience researching bacteria in diseases provides readers with useful background information on the role microbes play in life on earth before diving into the nuts and bolts on the overuse of antibiotics. I found the information touched-on in the first few chapters (microbes, human micro biome, pathogens and the development of antibiotics) to be the most interesting and informative parts of the book. The manner in which he lays out the basic biological elements of the human body and overall diverse function of its 100 trillion microbes is simply fascinating. While the major organs may get all the attention, the battle between the good and bad microbes is a perpetual struggle in which the outcome dictates healthiness over illness or life over death. Blaser effectively translates his fluency of medical science into a manner that is easy to digest for us “regular folk” … a big plus.

Once the biological basics are presented, Blaser dives into the gist of his argument that our current culture’s habit of over-prescribing antibiotics (especially to children) is resulting the plethora of headline-making medical crises. He succinctly points out that, like the military strategy of carpet bombing in lieu of a laser-guided strike, collateral damage occurs when powerful antibiotics are used to address a specific ailment … in addition to the bad microbes, the good microbes are eliminated as well, leaving more room for bad microbes to thrive and become stronger. He illustrates this by examining the common pediatric procedure of prescribing antibiotics to address strep throat; the strep disappears (for the moment), but the child’s natural immunity is weakened for future battles against pathogens. But he contends that it isn’t just doctors contributing to the problem; antibiotics are everywhere and the populace is consuming them almost daily without even knowing it via our food supply. The negative connotation of using antibiotics to fatten farm animals has become a cash cow (no pun intended) for those pedaling “organic” food. But, be forewarned; the high price you pay for “organic” chicken doesn’t factor-in the massive incidental consumption of antibiotics from a farms treated water supply.

Blaser backs up his arguments by providing medical science research/experiments that he personally was involved, as well as citing specific medical cases throughout the book. Common modern ailments, such as GERD, diabetes, asthma and some cancers were linked to the use of antibiotics in his medical research which certainly adds a degree of credibility. MISSING MICROBES is certainly thought-provoking and even down-right scary at times (especially the rise in MRSA cases). Our society is so fearful of pathogens that our efforts to get rid of them may actually be making them stronger. I even found myself recognizing that an underlying fear of germs has manifested itself into my use of hand sanitizer after using the gas pump … after reading MISSING MICROBES, that practice has ended.

Much of this book hammers away at the “too much of a good thing …” idiom; our culture so embraced the security of a “wonder drug” that eliminated a number of horrible maladies that maybe we’ve suppressed/ignored the possibility of potential consequences as well as ongoing biological evolution. While the book sheds light on a plausible concern, it is merely one professional’s opinion and I surely don’t believe this is a one-stop-shop resource on the issue. Is there another perspective on this subject? Did ALL of Blaser’s experiments support his argument? I always keep in mind that scientific declarations/postulations usually generate gracious (federal) funding when their hypothesis warrants enough attention (fear) … just a thought. Toward the end of the book, the author parallels the potential disaster presented by the overuse of antibiotics to that of “Global Warming” (uh oh). This simple, innocuous statement certainly made me wonder if antibiotic-overuse will be next “crisis” platform to be used/abused by politicians to manipulate/scare the masses … time will tell.
Profile Image for DIMELE Vidinė Vėjo pusė.
135 reviews11 followers
March 8, 2025
Kada paskutinį kartą girdėjote savo gydytoją perspėjant, kad antibiotikų vartojimas gali padidinti jūsų vaikui UŽL (uždegiminę žarnų ligą) ar astmos tikimybę? Atsakymas - niekada."
Beskaitydama išūžiau galvas savo draugams ir artimiesiems, kokia įdomi ir svarbi informacija pateikiama šioje knygoje. Kas skatina gyvūnų, auginamų mūsų maistui, bei gi, mūsų vaikų akceleraciją, nutukimą? Kokias ilgalaikes pasekmes vaiko mikrobiomai turi Cezario pjūvis, dabar jau net kaip galimas gimdymo pasirinkimas. H pylori bakterija-nuteisti ją ar išteisinti? Ji kelia mums daugiau problemų, ar jos nebuvimas?
Man patinka kokius klausimus kelia šis medicinos mokslų daktaras. Jis advokatauja ir gina H pylori. Tokia labai kontraversiška ir prieštaringa jo studija, bet susipažinti ir žinoti verta.
Tai nėra knyga, kuri jus mokys kaip gyventi sveikiau, ar puoselėti savo mikrobiomą, visgi duos jums labai naudingų kertinių patarimų, kurie tolimoje perspektyvoje pasiteisins. "Trumpalaikis antibiotikų poveikis ankstyvame amžiuje, sukeliantis laikinus normalių mikrobų sutrikimus, turi poveikį apykaitai. Ir tam poveikiui nebūtini nuolatiniai mikrobų populuacijos sutrikimai." Žinau, kad ne visi čia taip lengvai pamišę, kad skaitytų tokią mokslinę literatūrą savo malonumui, bet vis tiek jums rekomenduoju pabandyti. Parašyta nesudėtingai, su pavyzdžiais. Geriau vėliau, nei niekada. Būčiau perskaičiusi anksčiau, nebūčiau taip dažnai dėl šventos ramybės prašiusi gydytojų vaikams išrašyti antibiotikų, o jie tam spaudimui gan lengvai pasiduoda tiek pas mus, tiek Amerikoje, yra šalių išimčių. Gydytojai neturi laiko ir motyvacijos mums kalbeti apie šalutinius vaistų, vakcinų poveikius, mes turime domėtis patys ir pasverti pliusus bei minusus. Turime žinoti ir turėti teisę rinktis. Nes su tais pasirinkimais teks gyventi mums patiems.
Profile Image for Naomi Irwin.
10 reviews
November 1, 2021
I would like to start off saying this was for Chemistry class and I don't think I would read it if it hadn't been for class. However, I did find it interesting and super informative. It is slow but very interesting. I definitely had to take notes to keep focused but it was overall a great book for learning.
Profile Image for Keith McGowan.
Author 0 books
October 1, 2014
Whatever you are reading now, stop and get your hands on a copy of this book.

Antibiotics were once considered wonder drugs but now have become commonplace. Their overuse has led to concerns about the spread of "superbugs" (MRSA) that antibiotics will not be able to stop.

This author presents his research, albeit primarily on mice, that our overuse of antibiotics as well as C-section births and antiseptics has disrupted our microbiome - the relationship we have with bacteria. Not all bacteria is bad. We need it to digest our food, for example. That disruption may have led to a rash of modern plagues.

Have you wondered about the increase in food allergies, autism, and obesity? The common practice of prescribing antibiotics to young children may be a factor, if not the cause, of this increase. Broad spectrum (and least expensive) antibiotics may have killed the bacteria that caused the child to be sick but also the bacteria that would allow that child to digest peanuts or gluten. Early use of antibiotics may affect brain development in young children. Antibiotics are routinely used on livestock to get them to gain weight.

The author outlines the problem without a solution. He does not claim that the overuse of antibiotics is the only cause of our modern plagues, but he presents enough evidence to give me pause next time I reach for a hand sanitizer.
Profile Image for John.
Author 537 books183 followers
May 29, 2017
I carelessly picked this book up assuming it was going to be about the way we're breeding superbugs through our overuse -- abuse, in fact -- of antibiotics as growth-promoters in the agriculture industry. In fact, while Blaser -- a very distinguished bacteriologist and specialist in infectious diseases -- does discuss this issue, albeit at less length than I might have liked, the real focus of his book is the way that our overuse of antibiotics in humans, especially infants, is crippling our microbiome, the ecology of bacteria living in our stomach, gut, skin and elsewhere, many of whose species are crucial to our ability to resist disease. (Caesarean deliveries, in that they avoid the transfer of a basic bacterial colony to the baby from the mother's vaginal walls and anus, are also a problem in this respect.)

Blaser describes his work pursuing this line of research, beginning with his suspicion that Helicobacter pylori -- the very same H. pylori that Barry Marshall and Robin Warren identified in the mid-1980s as the cause of stomach ulcers (thereby deservedly gaining themselves the 2005 Nobel Prize in Physiology or Medicine) -- was not the outright villain that the medical profession thereafter assumed it must be. As Blaser explains, the way that the species of our microbiota generally function is that their behavior depends on context. There's no question that H. pylori may cause peptic ulcers and even, if those go untreated, stomach cancer in later life, but are we ignoring the benefits an internal H. pylori population can bring in youth and the succeeding decades?

Blaser believes that we are, and he and various teams have amassed a mountain of convincing evidence that our dearth of H. pylori and various other vital bacterial populations is contributing to such "modern plagues" as childhood obesity, asthma, allergies, diabetes and possibly many more. That "possibly" is important: Blaser is quite specific in pointing out that his suspicions that conditions like autism might be due to antibiotic overuse in the first few months of life are no more than that, suspicions, while the connections between microbiome debilitation and, say, childhood obesity are very well evidenced by multiple lines of research.

The agricultural abuse of antibiotics for growth promotion is part of this pattern. No one knows quite why injecting farm animals with antibiotics -- any antibiotics -- makes them grow faster and fatter. What we do know is that some of those antibiotics remain in the meat, poultry, eggs, milk and so on that we (vegans aside) consume daily, meaning that, on top of the temporary courses of antibiotics our doctors might put us on, we're subjecting ourselves to, in effect, a constant low-dose course of antibiotics, with all the damage that this can do to our microbiota and hence our health.

Obviously antibiotics are often medically desirable, even necessary for a patient's survival, and Blaser several times goes out of his way to stress this point. Similarly for C-sections. What he's saying is that many, and perhaps the vast majority, of the courses of antibiotics we take, or administer to our children, are completely unnecessary, and, through disrupting the relationship we've developed over hundreds of thousands of years with the bugs inside us, are causing a gross health crisis, one that may be threatening our welfare as a species. Overprescription is the primary problem -- hurried doctors find that dashing off a prescription for antibiotics gets patients through the surgery nice 'n' quick, and after all "they can't do any harm," they might well have a placebo effect, and being given a prescription generally makes patients feel they've gotten their money's worth, so to speak. (There have even been instances of doctors prescribing antibiotics for viral diseases, like colds!)

The same effect, although on a smaller scale, is being created by our modern use of C-sections as almost a routine procedure -- it's easier and quicker for the health staff -- rather than as something done exceptionally when the life of the mother and/or child might otherwise be at risk.

In both instances -- overprescription and C-sections -- we do of course have some control over what's going on. Rather than just obediently follow that course of antibiotics, we can question how necessary it actually is. Likewise, mothers can question if that C-section is really essential.

When I was reading Missing Microbes I was impressed by how readably and smoothly Blaser had written it. Afterwards I discovered that he was assisted in the text by science writer Sandra Blakeslee! Congratulations to both of them. The sole exceptions were at the ends of some of the chapters, such as Chapter 14, where final fragments of text didn't seem to make sense. I soon realized that the chapters concerned ended on the very last lines of their respective closing pages (p184 in Chap 14's case) -- in other words, I suspect some very clumsy copyfitting (done to bring back a line or two from the next page) was the culprit. Blaser should have a stern word with his publisher.

Here's what I'd suggest is the book's money quote (p198), although I'd guess the final mixing of metaphors may be yet another product of copyfitting:

We talk about a pre-antibiotic era and an antibiotic era; if we're not careful, we'll soon be in a post-antibiotic era. This now is a major focus of the CDC,* and I share its concern. But I am thinking about a different concept, not only the failure of antibiotics because of resistance but also the increased susceptibility of millions because of a degraded [microbiotal] ecosystem. The two go hand in hand, but in a smaller interconnected world the second is a deluge waiting to happen and growing each day.


Even if some of Blaser's more extended speculations turn out to be unfounded, I'd say this is a book that ought to be on the reading list of any inhabitant of today's world. The content is fascinating and, as I've said, extremely readable, and it seems to me that much of what Blaser has to tell us is highly important.

[* Funding set to be slashed if Trump's budget goes through. -- JG]
Profile Image for Jk.
369 reviews6 followers
February 14, 2014
I received a free ARC edition of this book through the Goodreads First Reads program and would like to thank everyone who made that possible.

I really enjoyed reading this. Some non-fiction and science books can be very dry, technical and boring but this was not one of those. It was very well-written and readable with some personal stories thrown in to illustrate certain points and the science was explained very well without going into unnecessary detail. I found the ideas and theories presented to be very interesting, thought-provoking and plausible. The ARC edition that I read does contain some minor editing errors here and there but nothing major and I am sure that they will have all those kinks worked out in the finished edition. Highly recommended!
Profile Image for Sweetwilliam.
172 reviews58 followers
September 28, 2018
Read this one to get an understanding of how antibiotics work and why you do not necessarily need a Z-pack for every sniffle. The author makes a case that we need more targeted antibiotics that do less collateral damage and that overuse or misuse of general antibiotics are killing off good microbes which the body needs and helping to render current drugs ineffective. Everyone should read at least the first half of this book. It is a great primer on antibiotics.
Profile Image for Autumn Nicole.
Author 4 books26 followers
April 8, 2022
I actually found this one really interesting. It's a nice length, not overwhelming like some of the other science books I've had to read this year 😂 I found it easy to understand and the author had a really balanced view on it all. He warns of the possible dangers of antibiotics but doesn't completely condemn them. They have their place. The only concerns I had with this book were mentions of evolution/billions of years and gobal warming, neither of which I believe in.
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