Addressing Antimicrobial Resistance by Changing Our Relationships with Microbes: Lessons from Japan.

Antimicrobial resistance (AMR) is a global health problem, but it is only the 'tip of the iceberg' of microbial disruption caused by antibiotics. Under the surface, cultural factors such as understandings of and attitudes toward microbes may play a significant role influencing relationships between humans and microbes. Western strategies to address pathogenic microbes and AMR often overlook the symbiotic relationship humans share with beneficial microbes (our microbiota), viewing humans as separate from nature and focusing on control. Given the increasing prevalence of novel pathogens, antimicrobial resistance, and chronic illnesses associated with disturbed microbiota (dysbiosis), alternative approaches are needed. Cross-cultural studies may provide ways forward. An exploration of Japanese perspectives on microbes through the lens of food and health reveals practices where microbes are often regarded as partners and friends rather than foes.