Missing Microbes, by Martin Blaser MD (Book Review Pedcast)

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


Come on in and sit a spell. Welcome to another book review edition of DocSmo.com. I’m your host, Dr. Paul Smolen, a board certified pediatrician in Charlotte, NC. I love learning about new ideas in medicine-that’s why I started this blog. So it’s with great excitement that I read a book by Dr. Martin Blaser, a medical doctor and expert in the normal and abnormal microbes of the human body, something that scientist now call the “human microbiome.” Sounds dull, doesn’t it? Well, I have to tell you that this book is anything but boring. It’s not many books that can change one’s fundamental thinking about one of a pediatrician’s most basic tools-antibiotics, but this book does just that.


Ask any Western doctor and they will tell you that things are changing. I went into my medical career, confident that we had tamed the microbial world with powerful antibiotics. Midway into my career, we began seeing super bugs being bred in hospitals and nursing homes.  Germs like MRSA staph, C diff, and even the wimpy microbe  pneumococcus became very tough cookies. Even more frightening, recently these germs have broken out of hospitals into our communities with terrible results.


But not all microbes are harmful. Researchers like Dr. Blaser are unraveling our biologic link to our friendly microbiome, working out how about 100 billion friendly bacteria inside and on your children, keep the child healthy and in balance. Some germs cause disease, like the ones I just mentioned, but most are part the a child’s defensive immune system. In other words, some germs can be your child’s enemy but most are your child’s ally, having evolved to the mutual benefit of your child and themselves.


Now for the revelation part of this book. Dr. Blaser’s conclusion after decades of study is that making’s use of antibiotics has fundamentally changed modern man’s microbiome, especially that of our children. He has found that  the reduction in diversity of the microbiome in today’s children, may be why we are seeing far more children with obesity, eczema, asthma, a food allergy called celiac disease, and other food allergies like peanut allergy.  He contends that being born by C-section, getting multiple courses of antibiotics during infancy and childhood, starts children off with dysfunctional immune systems. WOW!  Dr. Blaser contends that the same drugs that have saved literally millions of lives in the past half century have weakened our children in a fundamental way.


While Dr. Blaser realizes we can’t let completely give up the life saving usefulness of antibiotics, he does make a number of suggestions that would reduce their impact on all of us;

-Reduce the C-section rate to as low as possible. He contends that it is during the natural birth process that the microbiome is passed from generation to generation.

-The next time your pediatrician suggests the wait and see approach to antibiotics, you give it serious consideration.

-Pediatricians need to stop using broad spectrum antibiotics, those that stop the growth of a large number of bacteria in the body.

-Drop the hand gel idea and go back to soap and water which he contends has less impact on your child’s microbiome.

-Stop routinely giving antibiotics to animals on farms, simply to increase their weight.


Missing Microbes is an extremely thought provoking book, bringing decades of research out of the scientific journals and accessible and understandable to all of us. It is well written and full of relevant information for every expectant mother, new parent, and pediatrician for that matter. I give it 4.5 out of a possible 5 Doc Smo stars. I strongly recommend you read it and consider Dr. Blaser’s point of view. I think you will be glad you did.  Until next time.