Editing Broad-spectrum antibiotic (section)

=== Disruption of normal  microbiome ===
{{See also|Antibiotic misuse}}
There are an estimated 38 trillion microorganisms that colonize the human body.<ref>{{cite journal | vauthors = Sender R, Fuchs S, Milo R | title = Revised Estimates for the Number of Human and Bacteria Cells in the Body | journal = PLOS Biology | volume = 14 | issue = 8 | pages = e1002533 | date = 2016 | pmid = 27541692 | pmc = 4991899 | doi = 10.1371/journal.pbio.1002533 | doi-access = free }}</ref> As a side-effect of therapy, antibiotics can change the body's normal [[microbiota|microbial content]] by attacking indiscriminately both the pathological and naturally occurring, beneficial or harmless bacteria found in the intestines, lungs and bladder.<ref name="Martin">{{cite book | vauthors = Martin EA |year=2003 |title=Oxford Concise Medical Dictionary |edition=6th |isbn=978-0-19-860753-3 |publisher=Oxford University Press}}</ref> The destruction of the body's normal bacterial [[flora]] is thought to disrupt immunity, nutrition, and lead to a relative overgrowth in some bacteria or fungi.<ref>{{cite journal | vauthors = Rafii F, Sutherland JB, Cerniglia CE | title = Effects of treatment with antimicrobial agents on the human colonic microflora | journal = Therapeutics and Clinical Risk Management | volume = 4 | issue = 6 | pages = 1343–58 | date = December 2008 | pmid = 19337440 | pmc = 2643114 | doi = 10.2147/tcrm.s4328 | doi-access = free }}</ref> An overgrowth of drug-resistant microorganisms can lead to a secondary infection such as ''[[Clostridioides difficile (bacteria)|Clostridioides difficile]]'' ("C. diff") or [[candidiasis]] ("thrush").<ref name="Hopkins" /> This side-effect is more likely with the use of broad-spectrum antibiotics, given their greater potential to disrupt a larger variety of normal human flora.<ref name="Martin" /> The use of [[doxycycline]] in [[acne vulgaris]] has been associated with increased risk of [[Crohn's disease]],<ref>{{Cite journal|last1=Margolis|first1=David J.|last2=Fanelli|first2=Matthew|last3=Hoffstad|first3=Ole|last4=Lewis|first4=James D.|date=2010|title=Potential association between the oral tetracycline class of antimicrobials used to treat acne and inflammatory bowel disease|url=https://pubmed.ncbi.nlm.nih.gov/20700115/|journal=The American Journal of Gastroenterology|volume=105|issue=12|pages=2610–2616|doi=10.1038/ajg.2010.303|issn=1572-0241|pmid=20700115|s2cid=20085592}}</ref> although a later study indicated a link between [[acne vulgaris]] and [[Irritable bowel syndrome|IBS]] irrespective of the use of antibiotics.<ref>{{Cite journal |last1=Taylor |first1=Matthew T. |last2=Margolis |first2=David J. |last3=Kwatra |first3=Shawn G. |last4=Barbieri |first4=John S. |date=April 2023 |title=A propensity score matched cohort study identifying an association of acne, but not oral antibiotic or isotretinoin use, with risk of incident inflammatory bowel disease |journal=Journal of the American Academy of Dermatology |volume=88 |issue=4 |pages=841–847 |doi=10.1016/j.jaad.2023.01.014 |issn=1097-6787 |pmid=36682724|pmc=10033360 }}</ref> Likewise, the use of [[minocycline]] in acne vulgaris has been associated with skin and gut dysbiosis.<ref>{{Cite journal|last1=Thompson|first1=Katherine G.|last2=Rainer|first2=Barbara M.|last3=Antonescu|first3=Corina|last4=Florea|first4=Liliana|last5=Mongodin|first5=Emmanuel F.|last6=Kang|first6=Sewon|last7=Chien|first7=Anna L.|date=2020-02-01|title=Minocycline and Its Impact on Microbial Dysbiosis in the Skin and Gastrointestinal Tract of Acne Patients|journal=Annals of Dermatology|language=en|volume=32|issue=1|pages=21–30|doi=10.5021/ad.2020.32.1.21 |pmid=33911705| pmc=7992645 |issn=1013-9087|doi-access=free}}</ref>