Antibiotic Resistance: A Possible Role for Herbs in Clinical Practice

Presented by: Dr. Siouxsie Wiles, Phil Rasmussen, Dr. Nicky Baillie
Date: April 2017

Dr. Siouxsie Wiles presentation notes: Is this the end of the golden age of antibiotics?

Phil Rasmussen presentation notes: Herbal antibiotics - using herbs to fight bacterial infections

The Growing Problem of Resistance:

  • Antibiotic resistance is a major global health concern.
  • Over the past 25 years, antimicrobial resistance has expanded geographically and in complexity.
  • The WHO warns that without major developments, antibiotics may no longer be effective against common infections.

Scale of the Problem:

  • In 2009, antibiotic resistance led to over 25,000 deaths in Europe.
  • A 2016 U.S. study found that 26.8% of post-chemotherapy infections and up to 50.9% of post-operative infections involved antibiotic-resistant bacteria.
  • Antibiotic consumption in China is significantly higher than in Europe and the U.S.

Microbes of Concern:

  • MRSA, Clostridium difficile, multidrug-resistant Mycobacterium tuberculosis, Neisseria gonorrhoeae, Streptococcus pneumoniae, carbapenem-resistant Enterobacteriaceae, and extended-spectrum beta-lactamase-producing E. coli.
  • Gram-negative bacteria such as Pseudomonas and Acinetobacter are increasingly resistant.
  • Secondary bacterial pneumonia remains a leading cause of influenza-related deaths.

Factors Contributing to Resistance:

  • Overuse of antibiotics in healthcare and agriculture.
  • Poor adherence to treatment guidelines.
  • Spread of resistant organisms in healthcare settings.
  • Importation of resistant pathogens from endemic regions.
  • Direct correlation between antibiotic use and resistance development.

Mechanisms of Resistance:

  • Resistance genes originate from antibiotic-producing microbes.
  • Bacteria resist antibiotics through:
    • Impeding drug permeability.
    • Efflux pumps expelling drugs.
    • Enzymatic degradation/modification of antibiotics.
    • Alteration of antibiotic targets.

Multidrug Resistance (MDR):

  • MDR occurs through gene accumulation on resistance plasmids and efflux pumps.
  • Some strains, including MRSA, resist multiple antibiotic classes.

Mitigation Strategies:

  • Reduce antibiotic and antimicrobial use.
  • Implement public health policies to prevent infectious diseases.
  • Strengthen Antimicrobial Stewardship Programs.
  • Reduce antibiotic use in agriculture.
  • Develop treatments that target bacterial virulence rather than growth.
  • Use medicinal herbs and phytochemicals as alternatives or adjuncts to antibiotics.

Herbal Medicine as an Alternative:

  • Herbs have historically been used to treat infections.
  • Phytochemicals can combat bacterial infections and prevent resistance.
  • Potential applications include skin, respiratory, and gastrointestinal infections.

Antibacterial Plants:

  • Calendula, Cinnamon, Eucalyptus, Garlic, Ginger, Golden Seal, Hyssop, Lavender, Manuka, Myrrh, Oregano, Rosemary, Sage, Tea Tree, Thyme.

Tuberculosis (TB) & Herbal Treatment:

  • MDR-TB is on the rise, requiring prolonged treatment with toxic antibiotics.
  • Potential anti-TB plants: Garlic, Citrus species, Green Tea, Totara, and Berberis species.

Biofilm and Quorum Sensing Inhibition:

  • Biofilms protect bacteria from antibiotics.
  • Herbal compounds that inhibit biofilm formation:
    • Andrographis, Garlic, Guava, Ginger, Pomegranate, Centella asiatica.
  • Quorum sensing inhibitors (QSI) prevent bacterial communication and virulence.
  • Potential QSIs: Lemongrass, Guava, Ringworm Shrub, Gotu Kola, Silver nanoparticles.

Efflux Pump Inhibitors (EPI):

  • Efflux pumps remove antibiotics from bacterial cells, contributing to resistance.
  • Herbal EPIs: Black Pepper, Wormwood, Lovage, Berberine-containing plants.

Reducing Antibiotic Adverse Effects:

  • Herbal and probiotic adjuncts can mitigate antibiotic side effects.
  • Probiotics reduce antibiotic-associated diarrhea.
  • Milk Thistle and Globe Artichoke support liver health in patients on hepatotoxic antibiotics.

Honey as an Antibacterial Agent:

  • Manuka honey has strong antibacterial and biofilm-inhibitory properties.
  • Medical-grade Manuka honey is used in wound care.
  • Manuka honey enhances antibiotic effectiveness against MRSA and Pseudomonas aeruginosa.

Herbal Strategies for Respiratory and Urinary Tract Infections:

  • Herbs like Echinacea, Thyme, Ivy, and Pelargonium help manage respiratory infections.
  • Cranberry, Horseradish, and Nasturtium can reduce UTIs and antibiotic use.
  • Manuka honey prevents bacterial adhesion in urinary catheters.

Conclusion:

  • Herbal medicines can reduce the need for antibiotics, slow resistance development, and support immune health.
  • Further clinical research is required to validate the effectiveness of herbal treatments.
  • Combining traditional knowledge with modern research may offer solutions to the antibiotic resistance crisis.

 

Dr. Nicky Baillie presentation notes: March of the Microbes - Building Resilience. Treating Infections Naturally.

Antimicrobial resistance (AMR) is a steadily growing medical calamity.

Antibiotic Consumption in New Zealand:

  • Excessive community antimicrobial consumption in NZ in 2010.
  • 50% increase in total community antibiotic consumption in NZ from 2006-2012.
  • High consumption among children from 6 months to 5 years, with 62-77% of the cohort receiving antibiotics.
  • On average, 9.5 antibiotic courses were dispensed to each child in the GUINZ cohort in their first 5 years.

Effects of Antibiotic Treatment:

  • Antibiotic exposure in the first 2 years increases the risk of obesity, especially in boys and those treated within the first 6 months of life.
  • Much of the winter excess of antibiotics is due to amoxicillin prescriptions for URTIs.

Current Indications for Antibiotics:

  • Only prescribed for bacterial infections if symptoms are severe, there is a high risk of complications, or the infection is not resolving.

Adults:

  • Indicated for pneumonia, severe acute sinusitis, symptomatic UTIs, progressive cellulitis, dirty wounds/injuries/bites, meningitis, Giardia, and most STIs.

Children:

  • Indicated for systemic otitis media (<6 months), high-risk strep tonsillitis, pneumonia, UTIs, severe impetigo, and dirty wounds.

Antibiotics Not Indicated for Most:

  • URTIs, bronchitis, bronchiolitis, tonsillitis, ear infections, skin infections, and conjunctivitis.

Factors Affecting Immune Health:

  • Diet, breathing, environment, stress, and social support.
  • Environment includes pregnancy/birth factors, breastfeeding, housing, smoking, and poverty.

Social Support & Immunity:

  • Loneliness leads to increased inflammation and weaker immune response.
  • Social support and hugging reduce susceptibility to respiratory tract infections and severity of illness.

Building Resilience:

  • Improving diet and digestive health, breathing, family support, housing, social networks, and connections.

Treating Infections Naturally:

  • Traditional methods include rest, heat, supporting fever, and nursing care.
  • Herbal remedies: echinacea, thyme, kumarahou, golden seal, calendula, garlic, manuka, kawakawa.
  • Intravenous Vitamin C as an alternative treatment.

Case Studies:

  • Various cases of sinusitis, boils, conjunctivitis, UTIs, warts, LRTIs, bronchitis, bronchiectasis, and other infections.
  • Herbal and nutritional approaches used in treatment, often reducing reliance on antibiotics.

Summary:

  • Natural health practitioners are uniquely positioned to support immune health.
  • Confidence in craft, knowing when to refer, and having a peer network are essential for effective practice.
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