The hygiene hypothesis misnomer and its potential impact on strategies to tackle the global problem of antibiotic resistance

Allergic diseases including asthma, hay fever, eczema and food allergies have dramatically increased in industrialized countries over recent decades.   Although evidence still supports the concept that immune regulation is driven by host-microbe interactions, the term “hygiene” hypothesis is now being seen as a misleading misnomer for this concept.

Continuing use of this term means that the concept of being “too clean” persists in the minds of the public, who, as a result have lost confidence in the real meaning of hygiene. This is happening at a time when health agencies worldwide are recognising that “hygiene must be everyone’s responsibility”, driven by issues such as the unacceptable levels of gastrointestinal diseases, the ongoing threats of infectious disease pandemics  and the increasing numbers of immune-compromised people living in the community. Most importantly, hygiene  is now seen as a key part of strategies to tackle the global problem of antibiotic resistance;  reducing the level of infections results  in fewer people seeking antibiotic treatment, thereby limiting the selective pressure for   resistant strains.

This article is published in the newsletter of the Alliance for Prudent Use of Antibiotics The APUA Newsletter 2017 Vol. 35 No. 1 a