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Abstract：
In most instances where a pathogen has initiated an infection, the primary goal of the treating physician or pharmacist is to eliminate the pathogen. In the absence of knowledge of the precise identity of the problem-causing microbe, a broad-spectrum antimicrobial gives the best chance of success. This approach has saved many lives and is an invaluable tool in fighting infections. However, perhaps our current appreciation of the importance of the microbiome in human health should give us pause. We can regard the microbiome as a virtual organ within the human body, and we would surely hesitate to advance any therapeutic approach that would cause substantial damage to one of our organs. This is one consequence of many broad-spectrum antimicrobial therapies. There may be instances where a more precise approach would be useful. I have termed this \"selective depletion\"; a concept where pathogen numbers are curtailed by a narrow-spectrum inhibitor but the microbiome is protected and can play a role in restoring health and suppressing the outgrowth of the pathogen in the infected patient. It may well be that the best reservoir of microbiome-friendly antimicrobial agents is the microbiome itself, and I provide examples of where the microbiome has been mined for novel precision antimicrobials.
摘要：
在大多数病原体引发感染的情况下，治疗医师或药剂师的主要目标是消除病原体。在不知道引起问题的微生物的精确身份的情况下，广谱抗微生物剂提供了最佳的成功机会。这种方法挽救了许多生命，是对抗感染的宝贵工具。然而,也许我们目前对微生物在人类健康中的重要性的认识应该让我们停下来。我们可以将微生物组视为人体内的虚拟器官，我们肯定会犹豫推进任何会对我们的一个器官造成重大损害的治疗方法。这是许多广谱抗微生物疗法的一个结果。在某些情况下，更精确的方法可能会有用。我称之为“选择性耗竭”;一个概念，病原体数量被窄谱抑制剂减少，但微生物组受到保护，可以在恢复健康和抑制病原体在感染患者中的生长方面发挥作用。微生物组友好型抗菌剂的最佳储库可能是微生物组本身，我提供了微生物组被开采用于新型精密抗菌剂的例子。
