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.
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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.