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Dr. Stuart B. Levy | G force

A leader of the resistance

(Aram Boghosian for The Boston Globe)
January 10, 2011

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Q. As an expert in illness, what do you think is the best way to stay healthy?

A. I think it’s very simple. You eat well. You certainly drink lots of fluids. You wash your hands before you eat — I’m particularly eager to get that to occur at lunchtime. Exercise. Sleep is important, too — seven to eight hours is what’s recommended — certainly that’s key to the body’s defense.

Q. Do you take your own advice?

A. Yes. I try to. I swim every day.

Q. How do these things help prevent illness?

A. The virus lives on your mucus membranes. If you haven’t given them a healthy upbringing, so to speak, they are more susceptible to infection by viruses. These viruses can lay you up for several weeks. And they are destroyed by hand washing.

Q. Please explain what you mean by antibiotic resistance.

A. Resistant means it doesn’t succumb to the killing effects [of the antibiotic]. It is not that the person is resistant, it’s that the microbe that is causing the problem is resistant. The individual use of the antibiotic or the individual misuse of the antibiotic leads to a problem in which the bacteria are trained to resist the antibiotic. That may not occur to the person who’s misusing them, but to another member of that society or home.

Q. What do you mean by “another member of the home’’?

A. There are interesting studies that show that when you treat a person for acne with antibiotics for more than a week, the bacteria on the skin of the person taking the antibiotic and on other people in the household change. It’s like a second-hand smoke. The antibiotic could be used for a very good reason, but one has to be aware of the fact that it’s not only chasing after the microbe that is creating the problem, but also the good bacteria that are living with us.

Q. The bacteria are everywhere.

A. We are living in a bacterial world, a microbial world. Our evolution has taken place within that environment. Bacteria have seen dinosaurs come and dinosaurs go. They are not going to be destroyed.

Q. What about antibacterial soaps and products?

A. Quite honestly, others have shown, all you need is soap and water. I think alcohol-based disinfectants [such as Purell] are the way to go if you don’t have an area to go wash hands.

Q. You’ve lobbied strongly against the use of antibacterial products that leave a residue, the ones that don’t have alcohol, peroxide, or bleach in them.

A. I’m big on the nonresidue agents. Let’s say you bring in your meat and it’s got salmonella, and you’ve been washing it on the counter. You may take peroxide or alcohol to clean it. That gets rid of both good and bad [bacteria]. The surface is now available for good and bad, and generally if you haven’t brought more meat in, it’s the good in the environment that take over. If you use a product with triclosan [an antibacterial chemical found in liquid soaps, dishwashing liquids, and other antibacterial products], you use that there and what’s left on the counter, in the sink, is a small and increasing amount of residue of that chemical. Now, bacteria come and sit down. Only the resistant ones can live on that environment. So you kind of help them to take over the world.

Q. So, we should stop taking antibiotics for common ailments, particularly those that are caused by viruses — on which antibiotics are useless, right?

A. My message is prudent use of antibiotics.

KAREN WEINTRAUB

Interview was edited and condensed. Karen Weintraub can be reached at karen@karenweintraub.com

WHO
Dr. Stuart B. Levy
WHAT
Director of the Center for Adaptation Genetics and Drug Resistance and Professor of Medicine at the Tufts University School of Medicine