Re: Does constant treating IgA deficiency w/antibiotics have long term effects?

After AIDS, IgA deficiency is one of the most common immunodeficiencies. It affects both the mucosal and the systemic immune compartments. Some of the manifestations of the disease include infections in both mucosal and systemic tissues: sinusitis, otitis media, bronchitis, and pneumonias of viral and bacterial origin. Most of these diseases are treated with continuous treatments with antibiotics. Antibiotics are not components of our organism, and apart from their bactericidal or bacteriostatic properties on miroorganisms, they affect our metabolism, and in certain occasions can be directly toxic. Side effects can be: toxic, allergic, or biological. Briefly I will go to some of the scenarios.

The direct toxicity of antibiotics is variable. There some of them that interfere not only with bacterial functions but also with cellular functions. One of the targets is the arrest of division, and several antibiotics when prescribed in high doses or over prolonged periods can cause depletion of highly dividing cells, especially the cells of the blood. Another factor that contributes to toxicity is related to the metabolism of antibiotics in the body. Most of the antibiotics are metabolized in liver, and during their processing many toxic byproducts are generated, most of which can be handled by enzymatic activities that inactivate their toxicity. However these mechanisms can be overcome in conditions of high or prolonged use.

As antibiotics are not natural components of our organism, they can elicit immune responses. In many individuals these responses can be deleterious, leading to hypersensitivities or allergies. Thus, the prolonged use of antibiotics or the continuous change in the type of antibiotics can select for some of these reactions in susceptible individuals.

Finally, the action of antibiotics on microorganisms can generate two major problems. The first is the elimination of the normal flora in the skin and mucous membranes. This effect can alter enormously the homeostasis of those areas, which are maintained as micro ecological niches. For example, it can promote the growth of an abnormal flora that will destroy tissues. Fungal infections are very common after the normal flora is altered. In addition, the continuous use of antibiotics can select for pathogenic strains that are resistant not only to one, but to combinations of antibiotics, imposing a major risk not only to the affected individual, but also the population. In some occasions hospitalary infections with bacteria highly selected for their antibiotics resistance have been reported.

Thus, antibiotics are not only effective against bacteria. However their side effects can be controlled quite well.