Nutrition as a first-line defense before antibiotics

Caitlyn Getty, DVM, PhD, DACVIM (Nutrition), emphasizes the long-term effects of antibiotics on the gut microbiome, particularly with drugs like metronidazole, which can influence the gastrointestinal (GI) system for months or years. She advocates for considering nutrition as a first line of defense before administering antibiotics, as dietary management can help restore balance in the gut and potentially avoid the need for antibiotics. Getty suggests that antibiotic use should be carefully considered and reserved for when other treatments are ineffective, highlighting the importance of a balanced approach to animal health.

Below is the transcript, which has been edited for clarity.

dvm360: What should clinicians keep in mind about the potential long-term impacts of antibiotics on the microbiome?

Getty: A lot of times, we think about an antibiotic only having an effect right when we're giving it, and that effect can go away when we stop giving the antibiotic, but there's a lot of papers out there, especially about things like metronidazole, that once you put an animal on that, there can be effects within the GI microbiome, within other things for months to years afterwards, and so I think before we put an animal on an antibiotic, we need to try other things, or confirm that an antibiotic is really necessary.

And so, if we can do things like nutrition first, and see if we can get the effect that we're after, and then if we need things later down the road based on treatment response, then I think that makes a lot of sense. But just remembering that it's not just one and done, and we are not going to have any effects. We can see things for even 6 months to a year or longer. These issues within the gut are not necessarily a pathologic bacteria causing the issue. It's some other thing causing an imbalance within the gut. And so, if you can really manage that imbalance with something like nutrition, then there's never a need to give an antibiotic if you can get everything back into balance in that way.

Caitlyn Getty, DVM, PhD, DACVIM (Nutrition), is a board-certified veterinary nutritionist and PhD Scientist working to improve the health and wellbeing of dogs and cats through nutrition.