A new bidirectional hygiene approach to health, or “bigiene,” is being proposed as a solution as antimicrobial resistance becomes a growing concern. This new approach hopes to improve both individual and global health care by encompassing restoration of microbial communities along with antimicrobial warfare to promote balance.

This approach stems from the idea that over time microbes seek to balance their virulence so that they minimize harm to their host. However, things like antivirals and antibiotics get in the way of this natural process, and promote the occurrence of superbugs that then have resistance to current treatments. There is a thought that the best way to approach to antimicrobial therapy is to use more supportive forms of treatment, versus combative approaches.

Examples of this theory can be seen with fecal microbiota transplantation. This has gained popularity for treatments of C. difficile along with others in cases where no other options eliminate disease. This practice completely goes against the traditional views of the importance of hygiene to promote health, and conversely it uses microbial restoration to promote health. Similar examples can be seen with skin conditions and the use of microbial applications as oppose to antibiotic treatments.

This proposed natural and holistic approach focuses on personalization of microbial treatments. It involves balancing antimicrobial warfare against pathogens while restoring natural microbiological diversity. It includes treatments such as probiotics, natural air supplies with protective microbial infusion, microbiome-sensitive skin care as standard practice, and other similar interventions. Current findings indicate that even some hospital sterilization practices could be removed and replaced with microbial restoration, without compromising safety to patients.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4654184/