Antibiotic Stewardship

You divide bacteria into enemies and allies according to what they do for you. An antibiotic acts through biological susceptibility instead: beneficial organisms sharing the targeted vulnerability can be hit alongside the pathogen. The treatment therefore changes not only the infection but the microbial ecosystem around it. Stewardship begins by treating this collateral change as part of the intervention rather than an irrelevant side effect—a useful correction to the blanket idea of bacteria as “germs” captured by Bacteria are Awesome.

This model does not imply that antibiotics should be avoided. They can be lifesaving, and the danger of an untreated bacterial infection may outweigh disruption to the microbiome. The tension is between preserving a beneficial ecosystem and stopping an immediate threat—not between “natural” and “chemical” medicine.