It has been universally recognized that antibiotic use in the United States has been over-utilized, creating a crisis in health care, where many antibiotics are now ineffective due to the adaptation by bacteria, as well as the emergence of the many antibiotic-resistant strains of common bacteria. By 2016, the U.S. military reported that their research found a patient infected with bacteria that were resistant to all known type of pharmaceutical antibiotics, and the United States Centers for Disease Control and Prevention (CDC) stated that this was the "last piece of the puzzle" that will result in easy transmission of traits of pan-resistance to other types of bacteria. Moving forward we must learn to treat infection in a more sensible manner, recognizing that we can no longer just prescribe a long course of antibiotics whenever we suspect any type of infection, but we must test for specific pathogens and match specific drugs to them, quit taking antibiotics for viral illness, quit feeding antibiotics to farmed animals to stimulate growth, and integrate Complementary Medicine more to treat these infections and diseases caused by them. Standard medicine has ignored warnings of this impending crisis for decades, continuing to over-prescribe antibiotics purely to fulfill guidelines of treatment largely composed by the pharmaceutical industry to create profits, and ignoring the public health concerns. CIM/TCM can help with this problem in many ways, preventing infections, enhancing antibiotic effects to reduce the dosage or course and clear infections quicker, treating viral infections and symptoms, and addressing the adverse health effects from standard drug therapy, all with relative low expense and very minimal risk of any adverse health effects. Despite the long discouragement of this holistic therapy, which includes studied herbal medicine, more and more studies, some cited in Additional Information at the end of this article, clearly show that it is effective and safe, and now more than ever is vitally needed in a world where antibiotic resistant traits are now unfortunately widespread.
About 100,000 people die each year from hospital-acquired infections caused by antibiotic resistant strains of bacteria, and an increasing number of individuals are dying outside of the hospital from these types of bacterial infections. Today, at least 70 percent of the bacteria that cause infections in hospitals are resistant to at least one of the drugs most commonly used for treatment, and an increasing number of bacterial strains are resistant to all approved antibiotics, as well as other types of drugs now used. In 2012, the ECDC (European Centre for Disease Prevention and Control) and the U.S. CDC proposed the terms MDR (multi-drug resistant), XDR (extensively drug resistant) and PDR (pan-drug resistant) to classify data, especially for the now ubiquitous drug-resistant strains of Staphylococcus aureus, Enterococcus, Enterobacteriaciae, Pseudomonus aeruginosa, and Acinetobacter that are most often a threat in the hospital settings around the world. Antibiotic resistance is not only acquired by bacteria directly exposed to antibiotic overuse, but is now proven to be a genetic trait both passed onto bacterial offspring and also transferred via plasmids to other bacteria in the genus, not even needing reproduction to pass the genetic trait.
Bacteria as a species are learning how to protect themselves from antibiotics, and this presents a very dangerous threat in the future. In a recent study, 50 percent of cases of bacterial pneumonia in the hospital setting were shown to be antibiotic resistant, presenting an increasingly dangerous threat to the population. In a 2016 study of the prevalence of antibiotic resistance in healthy individuals, 100 staphylococcus isolates were obtained from a cross-section of hospital employees and 53 percent contained genes indicating multi-drug resistance to the common macrolide antibiotics erythromycin, azithomycin and clarithromycin, with another 8 percent with variable resistance to specific antibiotics (PMID: 27195143). These figures should be a cause of great concern to the public, and they represent not just an enormous death toll, but also point to the huge number of people affected by these resistant bacterial strains that do not die, many of whom may recover and acquire such serious problems as autoimmune disorders later in life due to the deep bacterial infection (see the article entitled Bacterial Endotoxins on this website). In fact, research published in 2016 from the Harvard University School of Medicine and Massachusetts General Hospital showed that these deeply penetrating low-grade bacterial infections lie at the heart of the Alzheimer's pathology, where amyloid beta protein complexes are shown to be expressed to encapsulate bacteria, Pleomorphic bacteria and bacterial endotoxins as an immune response, with other research showing that these deeply penetrating bacteria and endotoxins are clearly associated with the hyperphosphorylation of Tau proteins in Parkinsonism as well.
In 2013, Dame Sally Davies, chief medical authority in the British government, reported to the British Commons Science and Technology committee that antibiotic-resistant strains of bacteria, created by overuse of antibiotics, poses one of the greatest threats to the public in the near future, equal to the threat of terrorist attacks and pandemic influenza, and should be added to the national risk register of civil emergencies. She described "an apocalyptic scenario" where many patients going to a hospital for routine surgery would die from these superbugs, and modern medicine will have no effective treatment. She stated to the Commons: "There are few public health issues of potentially greater importance for society than antibiotic resistance.", as reported in The Guardian, January 23, 2013. By 2014, Mark Baker, clinical practice director for the British National Health for Health and Care Excellence (NICE), responded to an Oxford study that showed that women were much more likely to contract an antibiotic-resistant infection with caesarian sections, episiotomies, and protracted births as a result of epidural, which dramatically increases risk of infections, and published new guidelines for birthing calling for most women in the United Kingdom to utilize midwives and doctors in home birthing and specialized birthing clinics to prevent infant deaths from antibiotic resistant bacterial infections.
In India, extreme overuse of antibiotics resulted in close to 100 percent of newborn babies referred to neonatal intensive care wards having a multi-drug resistant infection by 2014, according to Dr. Neelam Kler, chairwoman of the department of neonatology at New Delhi's Sir Ganga Ram Hospital, as quoted in the New York Times on December 4, 2014. This resulted in an explosive birth mortality of over 58,000 in India in 2013, and researchers have noted that multi-drug resistant strains of bacteria apparently originating in India, many now resistant to any antibiotic, are being seen now across the globe, emphasizing the global nature of this threat. Also in 2013, the U.S. Centers for Disease Control and Prevention (CDC) released perhaps their first accurate report on the number of yearly deaths in the United States directly attributed to antibiotic resistant bacterial infections alone, estimating that 23,000 deaths per year occur that are directly caused by these infections and no other cause, with over 2 million Americans infected yearly with antibiotic-resistant strains. These numbers downplay the harm, as many Americans die from other causes with antibiotic resistant bacterial infections contributing to the death, and with CDC estimates of over 100,000 hospital deaths per year from bacterial infections, the present hard number may represent about a fourth of all of these yearly deaths. Many scientists believe we are approaching a time where early mortality from simple bacterial infections is about the same as the era before antibiotics were developed, all due to the long over-prescription of these profitable drugs. Modern medicine must learn to be more responsible in the future, and patients must realize that many attitudes in modern medicine must be seriously questioned, and can no longer be held sacrosanct.
A more comprehensive and holistic approach to prevention and treatment of bacterial infection and disease is sorely needed. For too long we have been told that the only treatment that we should consider is antibiotic therapy for all infections, leading to an attitude that there is no other way to prevent and treat this health problem. In so doing we have ignored the importance of the complex human immune system, membrane immune health, the protective Biome, integration of Complementary Medicine, and public health issues. While antibiotics are amazing and wonderful medicines, mostly derived from natural sources, they should have been just a part of treating bacterial infection and disease, and overuse of antibiotics, motivated by profit and not public health concerns, have now negated many of the benefits of these drugs and created a new problem with bacterial traits that are able to evade host immune responses better than ever. Improving immune function and capability, using a broader array of herbal and nutrient medicines, and improving the health of the symbiotic Biome and membrane immune health are the keys to a new and broader approach to bacterial infection and disease. Complementary and Integrative Medicine and Traditional Chinese Medicine (CIM/TCM) will play a big role in this more holistic and comprehensive approach.
The 'era of antibiotics' has long been touted as a 'miracle' of modern medicine that resulted in the amazing decrease in mortality in the United States, and while this has a ring of truth, the citing of antibiotic creation as a major contributor to our progress in healthcare has been greatly overblown. Penicillin, a chemical derived from natural sources, not synthetic, was not discovered until 1928, when Alexander Fleming discovered that a mold fungus that had contaminated a petri dish with Staphylococcus aureus appeared to inhibit this bacterial growth, causing the lysis of bacterial cells, and the fungus, Penicillium notatum, initially mistake as Penicillium rubrum, was used to make a simple extract called penicillin. There are many species of Penicillium fungi, and traditional herbal medicine has long used various fungi as valuable herbal medicines, the most prominent being the mushrooms, with some fungi thought to be the earliest forms of herbal medicine. Traditional fungi have produced some of the most useful pharmaceutical medicines, such as antibiotics, cholesterol inhibiting statins, anti-cancer drugs, immunosuppressants, and even fungicides. Today, species of benign Penicillum are stlll used to cure cheeses. The class of drugs we call antibiotics are derived from fungi. The 1928 discovery resulted in an antibiotic, penicillin, which could only treat local bacterial infections, though, not systemic infections, was considered a failure by many doctors. It was not until 1941 that a purification process resulted in the first patient in the United States being successfully treated for a threatening systemic infection from a miscarriage or abortion with an antibiotic. In 1942, there was only enough penicillin in the United States to treat 10 patients. During the second World War a huge amount of money was invested by the U.S. government to develop synthetic pharmaceuticals, including antibiotics, an important drug for soldiers, obviously. The problems of mass production and quick clearance of the drug by the kidneys necessitating frequent dosing presented problems in commercial pharmaceutical use, though, as well as the difficulties in oral pill form. It was not until about 1954 that actual scaled manufacture of penicillin was available, and it was not until about 1959 that the use of penicillin and the development of other types of antibiotics became common. The first chemical synthesis of penicillin, by Dorothy Hodgkin of MIT, occurred in 1957, and the initial forms were limited in scope. It was not until 1961 that more useful forms of penicillin were developed, the first being ampicillin.
The standard history of antibiotics states that the introduction of antibiotics is the reason why in 1900 the 3 main causes of death in the United States were infectious diseases, and that today death from infections is a minor cause of overall mortality. Realistically, the 3 leading causes of death in 1900 were viral influenza, pneumonia (of which most cases were viral), and tuberculosis (TB), which needs specialized drugs to treat, not common antibiotics. These 3 types of disease could not be treated, for the great majority of cases, with penicillin or other later common antibiotics. The U.S. CDC states that since 1935 the leading causes of death were cardiovascular disease and cancer, and by 1941 infectious diseases were not a cause of a significant percentage of deaths, and most to these were still viral diseases. The U.S. CDC also still states that the amazing decrease in U.S. death rates from 1935 to 1954 could be largely attributed to antibiotics, but we see that these drugs were not widely used during this period. The most amazing factors that led to a decrease in deaths from infections were sanitation, toilets and sewage systems, water treatment, food safety, access to hospital care, the introduction of automobiles and elimination of animals and animal waste in the cities, and an increase in income and standard of living for the poor and middle class. In the first half of the 20th century, the death rates for the poor and non-white population was 5-10 times higher than for the white population with a reasonable income. By the time effective and available prescription of antibiotics occurred, in 1961, the leading causes of death in the U.S. were heart disease, cancer, cerebrovascular diseases, chronic lower respiratory diseases, diabetes, influenza and pneumonia, chronic liver disease, and accidents, almost none of which could be prevented by antibiotic use. To continue to state that the decrease in mortality was largely attributable to antibiotics is a misconception, even though antibiotics are an extremely valuable medicine. On the other hand, the present state of affairs with gross overprescription of antibiotics, large use of antibiotics to stimulate food animal growth rates, and the antibiotics now in our waters from runoff and disposal, presents an enormous threat to public health via the creation of a learned genetic response in bacteria that better evades the natural human immune complement system. The importance of the 'era of antibiotics' has been used to justify this enormous overprescription and overuse of antibiotic drugs, and the harm from this malpractice is now a major threat to the world. New types of antibiotics are not being discovered in pharmaceutical research, and a new approach is needed to move forward.
Besides the threat of widespread antibiotic resistance, research in recent years has entered the previously off-limits area of long-term adverse effects of antibiotic use, uncovering an alarming array of concerns. Medicine has long held that antibiotics are so crucial to healthcare that they should not be questioned, but this has led to a dangerous attitude of overuse, as patients and physicians came to believe that there were no real long-term adverse consequences to antibiotic use. This very dangerous societal belief was coupled with advice to avoid holistic antimicrobial therapy in Complementary and Integrative Medicine (CIM/TCM) when appropriate. Research is showing that adverse side effects of antibiotic use contribute heavily to growing health problems with obesity, allergies, Metabolic Syndrome, Inflammatory Bowel Disease, Irritable Bowel Syndrome, autoimmune disorders, and even neurological disorders such as autism. We need to finally face the facts, and not rely on old and outdated belief systems.
A New York Times Health article published on November 13, 2012, entitled Antibiotics Are a Gift to Be Handled With Care, outlined the growing concern over alterations in the Biome, or symbiotic bacterial and microbial colony that makes up a majority of our cells, which may account for serious and prevalent adverse consequences of antibiotic use, particularly in pregnant women and young children. Dr. Martin J. Blaser, chairman of medicine at New York University School of Medicine published a study in The International Journal of Obesity in 2011 that showed analysis of a large number of British children with obesity, and increased risk of obesity later in life by 22 percent when treated with an antibiotic in the first year of life. Such research was prompted by the widespread use of antibiotics in the food animal industry to promote faster weight gain. Other studies have linked development of asthma and inflammatory bowel disease with early use of antibiotics. In a May 27, 2014 article in the New York Times, Dr. R Balfour Sartor M.D., a gastroenterologist at the University of North Carolina School of Medicine, is quoted: "Early exposure to antibiotics, especially during the first 15 months of life, increases the risk of developing Crohn's disease, though not ulcerative colitis. If there's a family history of IBD, particularly Crohn's disease, antibiotics should be used only for a documented bacterial infection like strep throat or bacterial meningitis. And when antibiotics are needed, probiotics can be used during and afterward to minimize their effect and restore the normal bacterial population of the gut."
The use of antibiotics to treat viral illness has been widespread for some time, despite the obvious failure of antibiotics to affect the viral infection, and while antibiotics should be used to save lives when confirmed and threatening bacterial infections occur, the use of antibiotics has far exceeded this obvious need. Even today, with decades of warnings, medical doctors routinely prescribe antibiotics when no bacterial infection has been confirmed, although testing and culturing a sample of bodily fluid for pathogenic bacteria is a rather simple test. The avoidance of a bacterial culture with infection has no justification other than to sell more antibiotics, and the common statement that the test takes too long could be easily overcome by hospitals and clinics with just a small amount of effort. A culture of justification for this very harmful attitude and behavior has proved difficult to reverse. The age of pretending that antibiotics are harmless is over, yet the persistence of prescription continues, and in fact has greatly increased for the most vulnerable patients, infants. Taking advantage of patient's fears has been at the heart of this bad medical practice.
Antibiotic-resistant strains of pathological bacteria are much more difficult to control than we have assumed. A research project, reported in the New York Times Health section of August 22, 2012, conducted in one of the most sophisticated hospitals in the United States, the Clinical Center of the National Institutes of Health (NIH) in Bethesda, Maryland, tracked a lethal antibiotic-resistant strain of Klebsellia pneumoniae with genetic sequencing to find out how it had spread in this hospital when the strictest standards of isolation had been implemented. The results of this study, published in the journal Science Translational Medicine online, showed that the bacteria was able to survive for weeks in the moisture of a seam in a respirator that had been disinfected, as well as the drainage pipes of the sinks. Dr. Julie Segre Ph.D., a genome researcher at the National Human Genome Research Institute of the NIH, stated: "We didn't understand the environmental stability of this organism...this long latency period was very worrisome." Strict handwashing and disinfectant, as well as patient isolation, did not prevent the spread of the antibiotic-resistant strain of Klebsellia to patients outside of the area where the infected patient was isolated. Worse, the subsequent infections occurred more than a month after the patient was discharged, and 6 patients died from this pneumonia. This emphasizes that not only must we take extraordinary measures to control such antibiotic-resistant strains of pathological bacteria, which will be very expensive, and add to the already explosive growth in health care costs, but that decreasing the development of such antibiotic-resistant strains of bacteria is an extremely important issue. The overuse of antibiotics must stop now, and we must pay more attention to enhancing the human immune system and the human biota, our first line of defense.
Although MRSA, or methicillin-resistant Staphylococcus aureus, is now a well-known acronym, the actual array of antibiotic resistant strains of bacterial and other microbial infections are now numerous and increasing at a logarithmic rate due to the widespread practice of antibiotic overuse and use of antibiotics in corporate farming to stimulate growth in feedlot animals. By 2014, Carbapenem-resistant Enterobacteriacae, or CRE, is becoming suddenly well-known as well. This type of deadly antibiotic resistance involves a number of common gastrointestinal bacteriae that infect us that are resistant even to a newer class of antibiotics, Beta-lactams, which includes Carbapenum, Amoxicillin, Piperacillin, and Ampicillin. Unlike MRSA, a term for one specific type of bacteria resistant to one type of antibiotic, CRE is an acronym for a family of bacteria that are resistant to a family of antibiotics. This is serious. Common types of bacteria that infect our gastrointestinal tract, especially during hospital care, include Escherichia col (E. coli) and Klebsellia, such as Klebsellia pneumoniae, which of course also infect the lungs and causes many deaths from pneumonia in the hospital. These bacteria have evolved enzymes that break down this group of antibiotics and renders them ineffective.
While MRSA was dangerous, CRE is deadly. Some CRE bacterial families have become resistant to almost all available antibiotics, and the potential for new types of antibiotics are just not apparent. Antibiotics introduced into the market in recent decades are largely just versions of past antibiotics. Studies have shown that CREs can result in the death in half of all patients infected, according to the U.S. Centers for Disease Control and Prevention (CDC)! A type of antibiotic used mainly to treat antibiotic-resistant bacterial infections is Vancomycin, and now Vancomycin-resistant Enterococci (VRE) are emerging as a serious threat as well. Enterococci are types of bacteria that are in fact normal to the intestinal tract and female genital tract, and are often found in the environment outside of the body as well. By creating antibiotic resistance in many of these types of common bacteria we have created a deadly type of illness that we cannot treat, and that mainly occurs in weakened individuals in the hospital setting. While we have noted a number of deadly viruses with a high mortality rate, these viral illnesses can be contained and treated, and vaccines can be created. We cannot treat or prevent a bunch of bacterial infections that are commonly seen in hospital care that are resistant to almost all known antibiotics. The options for treatment and prevention are largely limited to increasing the host immune strength and utilizing Complementary and Integrative Medicine (CIM/TCM). The resistance to acknowledging the scientific proof that CIM/TCM treatment protocols work and are safe, and finally integrating them into care, compounds this public health threat.
The reasons why we now have so many strains of bacteria acquiring antibiotic resistance, and genetically traited resistance to many types of antibiotics, may be centered on the way bacteria evolve and pass genetic information to one another rapidly. Study of bacteria has shown that this type of life form is intelligent, actually making decisions as a colony to adapt to environmental change, yet human science is still trying to determine exactly how they accomplish this task. We do know from the study of bacteria that genetic information has always been passed within bacterial colonies not only be reproduction of the genome, but by altering the genome via plasmids and viruses. This elaborate system is explained in the wonderful book by Lynn Margulis and Dorian Sagan entitled Microcosmos. We now know that strains of bacteria have acquired antibiotic resistant traits via plasmids, and this means that antibiotic resistance can thus spread very rapidly around the world. Bacteria are outsmarting humans. A 2008 paper on this topic by Professor P. M. Bennett of the University of Bristol, in the United Kingdom, starts by stating: "Bacteria have existed on Earth for three billion years or so and have become adept at protecting themselves against toxic chemicals. Antibiotics have been in clinical use for a little more than 6 decades. That antibiotic resistance is now a major clinical problem all over the world attests to the success and speed of bacterial adaptation."
By 2015, a crisis in antibiotic-resistant strains of Clostridium difficile (C. difficile), the most common cause of hospital-acquired (nosocomial) intestinal infections, or enteritis, occurred, leading to a large number of patients in hospital care, especially postoperative, with a serious enteritis. This Clostridium difficile enteritis also was found to recur quite frequently, due to the fact that Clostridium bacteria is spore producing, producing a latent infection even after it is eliminated, if an effective antibiotic can be found for the original infection. Experts in infectious disease, in a May 26, 2015 New York Times article entitled Drug Overuse Begins an Epidemic, such as Dr. Daniel A. Leffler and Dr. J. Thomas Lamont, of the Beth Israel Deaconess Medical Center, in Boston, Massachusetts, U.S.A., were quoted in the New England Journal of Medicine as stating: "The most important risk factor for C. difficile (Clostridium) infection remains antibiotic use, (with) Ampicillin, Amoxicillin, Cephalosporins, Clindamycin and Fluoroquinalones the antibiotics that are most frequently associated with the disease, but almost all antibiotics have been associated with (this) infection." The reason cited was that gross over-prescription of antibiotics destroys the gut Biome, or bacterial balance, that is the main protection against such recurrent intestinal infections. Compounded by the fact that gastric acid inhibiting drugs, commonly prescribed, also increase the risk of C. difficile infection, and in 2011 the U.S CDC reported that at least 14,000 deaths from C. difficile infection occurred in U.S. hospitals, with numbers rising yearly, the scenario of over-prescription of antibiotics continuing relatively unabated has even begun to publicly alarm Medical Doctors, who have been loathe to criticize any pharmaceutical protocol. In this New York Times article, Dr. Dale N. Gerding, of Loyal University in Chicago, stated that the problem in the U.S. was that 80 percent of antibiotics were still being used inappropriately for viral infections, despite a decade of stern warnings and realization of this crisis, and that in countries such as the United Kingdom, where a program of more judicious antibiotic use has been implemented, the incidence of C. difficile infection in hospitals is declining, not increasing like it is in the U.S. Clostridium difficile infections of a serious nature, with patients over age 65 ten times as likely to to become infected, are now increasingly seen in the U.S. outside of the hospital as well, and experts now agree that this is because the patients acquired the C. difficile infection in hospital clinic visits, with the spores creating a serious infection a month or two later. In one study, most of these cases involved prescriptions of antibiotics with their hospital clinic visit or procedure, according to Dr. Gerding. Such stubborn persistence of antibiotic over-prescription and ignoring of the consequences are unfortunately standard behavior in the U.S.
Such health problems as autoimmune disorders, whose incidence in the United States has grown explosively in the last few decades, may also be indirectly associated with overuse of antibiotics and antimicrobial chemicals. Not only direct bacterial endotoxin stimulation of a chronic nature, but also an acquired immune dysfunction in early childhood and fetal development, may be responsible for the rise in autoimmune disorders. The Hygiene Hypothesis surmises that a lack of early immune response to common microorganisms, coupled with a deficient intestinal Biota or symbiotic intestinal bacteria and other microorganisms, contributes to an imbalanced immune response later in life. The human immune system is adaptive, and exposure to pathogens stimulates the development of the complex immune responses as we grow. Research has discovered that lack of an immune response to common environmental pathogens in the developing fetus and young person may lead to a deficiency in long-lived T cells, generating more cycles of short-lived T cells to respond to pathogens, which leads to more autoimmune T cells. This phenomenon, coupled with increased environmental immune stress, and more vaccinations that target just the Th2 (T helper cell type 2) responses, may lead to an imbalance of Th1 to Th2 immune responses that drive most autoimmune disorders. The overuse of antibiotics in humans and feed animals, coupled with diets that do not supply the materials to create and maintain a healthy biota, or gut immune response, the increased use of vaccines, and the increased use of antimicrobial chemicals in cleaning and hygiene products, leads to a state of hygiene that actually causes immune missense. The phenomenon has been associated with autoimmune disorders, autism, type 1 diabetes, acute lymphocytic leukemia, and allergic disorders.
In December of 2013, the United States Food and Drug Administration (FDA) released a number of warnings concerning the safety and effectiveness of antibacterial soaps. New guidelines called for the end of the GRASE (generally recognized as safe and effective) classification for these products, a classification that predates current FDA testing guidelines that has allowed a wide variety of common industrial products to escape current assessment for safety and effectiveness, even as a multitude of studies show that the products are potentially harmful and/or ineffective for what they are advertised to do. The FDA stated: "Although consumers generally view these products as effective tools to help prevent the spread of germs, there is currently no evidence that they are any more effective at preventing illness than plain soap and water. Further, some data suggest that long-term exposure to certain active ingredients used in antibacterial products - for example, triclosan (liquid soaps) and triclocarbon (bar soaps) - could pose health risks, such as bacterial resistance or (negative) hormonal effects." Colleen Rogers Ph.D., a lead microbiologist at the U.S. FDA stated: "New data suggest that the risks associated with long-term, daily use of antibacterial soaps may outweigh the benefits." Such active ingredients as triclosan and triclocarbon are found in virtually all commercial antibacterial soaps and have been shown to alter the way hormones work in the body. Triclosan is also widely used in pesticides, and environmental assessment in recent years has bolstered the imminent restrictions on this and other similar chemicals by the U.S. Environmental Protection Agency (EPA). To read these 2013 FDA warnings, click here: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm378542.htm and here: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm378393.htm . Of course, these warnings and guidelines were dramatically resisted by the industry, and the ubiquitous harm and, of course, profits, that were generated by the ten year delay in public warning may be enormous.
The persistent belief in, and use of, these antibacterial chemicals in soaps, cosmetics, and household cleaners, and inappropriate overuse of antibiotics, will also be difficult to change. Not only antibacterial soaps, but many cosmetic products, such as facial foundation, skin lightening cream, lipstick, mascara, cleansing and moisturizing creams, deodorants, antiseptic ointments, pain reducing sprays, toothpastes, and acne products contain triclosan, many of which have brand names that suggest that they are natural health care products. In addition, clothing, yoga mats, air filters, baby covers, towels and paints have contained triclosan. Triclosan has been found to chemically mimic thyroid hormone and bind to thyroid hormone receptors, blocking them, and is able to negatively affect the immune system and contribute to allergic disease. Other studies have shown the potential to impair the excitation-contraction coupling in both smooth and skeletal muscle, and triclosan may combine with chlorine to form chloroform, a probable human carcinogen. In addition, recent studies have finally proven that bacteria, fungi and other pathogenic microbes have developed resistance to triclosan, and that these products have contributed to antibiotic resistance as well. The variety of small harms to thyroid function, other aspects of the endocrine system, the immune system, and antibiotic resistance demonstrate the need for a more comprehensive outlook on antimicrobial and antibiotic use and harm.
As the acceptance of the fact that as dysfunction of the intestinal biota and gut immune responses occur the risk of autoimmune disorder is greatly increased finally is accepted by physicians and the public, there has grown, of course, and oversimplification of the explanation for this connection. Today, the mantra of oversimplification of this important health issue is that evil glutens are the only concern, and that adopting a gluten-free diet will cure or protect one from autoimmune disorder. While gluten intolerance is associated with celiac disease, a disorder of dysfunctional immune reaction and poor health of the small intestine membrane, simply avoiding gluten, a nutritious protein, will not solve this problem. Avoiding gluten in celiac disease is important, and will decrease symptoms, but only a restoration of gut health and function, as well as a healthy microbiota, damaged with overuse of antibiotics, will protect one from the pathological mechanisms that create the Th2/Th1 imbalance and deficiency of long-lived T cells that drive most autoimmune disorders. Restoration of the gut membrane health and immune function will not only help to prevent and treat autoimmune disorders, and decrease digestive symptoms, but will eventually allow you to again eat glutens without adverse effects. Simply avoiding glutens is not the most intelligent way to solve this problem. A more thorough and holistic treatment protocol is needed, and using antibiotics only when necessary is of prime importance.
The U.S. Center for Disease Control, or CDC, has deemed antibiotic resistance a serious threat to public health, but standard medicine has been slow to change its prescribing guidelines. In 2013, Sally Davies, the chief medical officer of Great Britain, formerly declared antibiotic resistance a 'catastrophic' global threat to the public, equal in rank to terrorist attacks and other civil emergencies. In 2016, a woman in Pennsylvania tested positive for a strain of E. coli in her urine that was resistant to all known pharmaceutical antibiotics, and contained a gene known as MCR-1 that is resistant to colistin, the last line of defense against antibiotic-resistant strains of gram-negative bacterial infections in the hospital setting. This may have been the first proven case of a truly pan-drug-resistant bacterial infection in the United States, but these have been increasingly documented around the world in recent years. Dr. Thomas Frieden of the U.S. CDC stated that "the medicine cabinet is empty for some patients...it is the end of the road for antibiotics if we don't do something." That something must be more holistic this time, with a comprehensive approach to infection that stops treating this complex subject lightly. Obviously, patients need better microbial Biome balance and health, healthier membrane immune responses, a wider array of tools to help the body counter pathogens, and more use of Traditonal Medicine in the form of herbal formulas and acupuncture. In the near future humanity is faced with both a viral pandemic which we are not prepared for and now many cased of pan-resistant pathogenic bacterial infections. In recent years we have found finally with the emergence of genetic mapping that the number of microbial species on the planet numbers not just in the millions, but in the trillions, and the era of human scientific arrogance must end regarding the ability to keep up with Nature.
Professor Davies stated: "Antimicrobial resistance (to antibiotics) is a ticking time-bomb not only for the UK but also for the world...Governments and organisations across the world, including the World Health Organization and G8, need to take this seriously." For this reason, it is ethically imperative that the individual patient decides to use antibiotics only when necessary, and only for the effective therapeutic course, avoiding overuse, which may create adapted resistance by the bacteria. The problem is still poorly understood by the public. It does not involve resistance by an individual to the antibiotics, but increasing levels of adaptive resistance by bacterial strains. Creation of antibiotic strains of bacteria and other microbes affects the whole community. In the individual, antibiotic strains of bacteria will not be affected by antibiotics when they are used, and so while healthy bacteria are destroyed when treating an infection, these antibiotic strains survive and dominate the gut biota, creating further unhealthy biotic imbalance. Even individuals that have not personally overused antibiotics are profoundly affected by antibiotic resistant strains of bacteria, though, and they are affected by the altering of the bacterial balance in our bodies that has resulted from the enormous amount of antibiotics accumulating in our environment as well. The ill effects of antibiotic-resistant strains of bacteria are broad, and not just limited to acquiring a serious MRSA infection. This does not mean that an individual should just avoid all antibiotics, as a threat of serious bacterial infection requiresantibiotic use, just adopt sensible use of antibiotics, not overuse.
Complementary and Integrative Medicine (CIM/TCM) offers some healthy alternatives and complements to antimicrobial therapy with herbal antibacterial, antiviral and antifungal chemical extracts that can be integrated into your health care when appropriate. Complementary and Integrative Medicine also offers the patient effective means to prevent infection and improve the health of the immune system, as well as to more effectively restore the gut and membrane Biome, and provide expert guidance in dietary and nutritional advice that directly impacts the gut Biota. This in no way means that there is a binary choice between antibiotics and herbal medicine. To make this choice to integrate Complementary Medicine in the treatment of milder bacterial infections, viral infections, fungal infections, etc., and to support better immune function and membrane health, the patient needs to know the facts, and this article provides many useful facts for patients and their physicians to develop a new comprehensive and holistic health strategy.
Not only the widespread over-prescription of antibiotics, but also excessive prescription of other drugs to treat virulent diseases is causing a huge health crisis of drug resistant disease around the world. Eventually, this worldwide health problem will creep into the lives of many of us in the U.S. who have been removed from such common problems as tuberculosis and malaria, as globalization and population shifts with immigration and travel bring these drug-resistant virulent diseases to our neighborhoods. Drug-resistant strains of microbes and viruses that cause TB, malaria, serious viral diseases, and even fungal disorders, such as candidiasis, are appearing in an accelerated manner that we need to be concerned with. In 2010, the World Health Organization (WHO) released a study that showed that a third of the world has latent tuberculosis, and in 2012, a study published in the Lancet found that in 1278 randomly chosen TB patients in 7 countries, almost 44 percent showed a strain of TB resistant to at least one second-line drug, such as quinolone antibiotics (e.g. Cipro), aminoglycoside antibiotics, or one of the other antibiotic types now routinely prescribed. The over-prescription of pharmaceutical drugs is the reason for these drug-resistant strains of microbes and viruses, along with the enormous growth in the use of these drugs to treat the animals we grow for food on huge corporate farming and animal husbandry enterprises. Even the incidence of inflammatory problems associated with Helicobacter pylori in the stomach is now significantly affected by the exponential growth in drug-resistant strains of H. pylori. A key part of the solution to this problem is the acceptance of Complementary and Integrative Medicine (CIM/TCM) by the public and medical doctors to treat virulent diseases when appropriate, or to integrate these practices into standard care to reduce the dosage and course of the drug prescription. Even large animal feedlots could benefit from the incorporation of herbal and nutrient medicine into the care of their animals, instead of overuse of pharmaceutical antibiotics.
Besides overprescription of antibiotics to patients, there are a number of other industrial practices that are perhaps contributing to the increase in antibiotic resistant strains of microbes that need to be addressed by the public and its elected officials
Besides the overuse of antibiotics by humans, a more significant threat is perhaps the overuse of antibiotics by large meat producers. The Union of Concerned Scientists, in 2001, estimated that 84 percent of all antibiotics used, or overused, in the United States were used in agriculture, and that 70 percent of these drugs were used simply to promote animal growth, not to treat infection.
Even industry trade associations admit that an estimated 13 percent of antibiotics used in the raising of beef, pork and chicken were used solely to promote growth, and we now know this to be just a 'spin' to counter the dangers of this practice. The United States government has responded to the CDC reports of the threat to public health by antibiotic overuse by trying for over 30 years to restrict the overuse of antibiotics in the raising of meat animals in confinement, yet industry lobbying has continually killed these bills and laws. These facts are alarming in many ways. Not only are antibiotics being used in the water and animal feed, and creating widespread strains of antibiotic resistant bacteria, as well as potentially contaminating human water sources, but we see that the antibiotics are significantly affecting the animal hormonal regulations, such as growth factors, potentially posing more complicated health threats to humans that are taking too many antibiotics. A June 28, 2010 article in the New York Times outlines these issues. Click on this link (with cookies accepted in your preferences) to read this article: http://www.nytimes.com/2010/06/29/health/policy/29fda.html?scp=1&sq=antibiotics&st=cse. A 2013 study at Johns Hopkins Bloomberg School of Public Health, published in the September issue of JAMA Internal Medicine, found that in a study of 440,000 health records, that patients living near large industrial animal farming facilities, or the areas where the manure from these large animal feedlots were dumped, showed a 38 percent increased risk of acquiring a MRSA (methicillin-resistant staph aureus) infection. Finally, in 2012, a federal judge issued an order to the FDA to enforce its 1977 ban on the use of antibiotics in animal feed due to a public health threat, but this may now be found to be too late. Of course, this ruling too is being challenged by the meat growers, as the cost of actually producing livestock for human food consumption in healthy environments that do not need massive use of antibiotics is much higher. Profits are obviously much more important than public health to industrial meat producers. A rise in the cost of meat, though, is nothing compared to the cost of ill health generated by both the epidemic of antibiotic-resistant bacteria and the adverse health effects of all of this antibiotic in our environment. Consumers may need to speak up to actually change this practice. Purchase of healthy meat from animals that are allowed to graze in normal pastures rather than be cruelly confined to crowded unhealthy feedlots and cages will help to reverse this public health threat. With a growing human population we need to consider reducing meat consumption to make this possible.
The decades of heavy use of antibiotic drugs in the meat industry points to the fact that these drugs affect the endocrine system and metabolism in ways that spur rapid growth and are obviously linked to obesity, abnormal growth factors contributing to an array of diseases, and other health concerns. In 2014, Dr. Martin Blaser M.D., Chair of the Department of Medicine at New York University, and a long-time research specialist of the human Biome, released proof that antibiotic overuse is directly linked to unnatural growth and obesity. This effect is especially profound in infants and children, where the developing microbial Biome is still developing, forming important symbiotic mechanisms linked to the individual genetic and epigenetic makeup of the child. Dr. Blaser believes that this could be the most important contributor to the large increase in obesity rates in children and later in their adult life. With the vast majority of antibiotics now being used in feedlot animals, the effects of this antibiotic contamination in runoff into our drinking and agricultural water is of prime concern. While the animal food industry cites studies that show that little of these antibiotics are intact in meat that is consumed, the real threat comes from the antibiotics excreted by the animals and sent into our water systems, as well as the manure from these feedlots, which may end up in fertilizer. In addition, the metabolic effects on the feedlot animals from antibiotics may result in growth factors that may also affect the consumer indirectly, not from direct measurable amounts of the antibiotic chemicals themselves in the meat.
Another serious, but disputed, cause of antibiotic resistance is the overuse of antibacterial chemicals in the United States, especially chemicals that leave long-lasting antibacterial residues behind, such as triclosan (a bisphenol), triclocarban (an anilide), and benzalkonium chloride (a quarternary ammonium compound), as well as biguanides (chlorhexidine, alexidine and polymeric biguanides), PCMX (halophenols), phenols, cresols, heavy metals such as mercury compounds, and other quarternary ammonium compounds (cetrimide and cetylpryridinium chloride). These chemicals are now ubiquitous in a variety of soaps, household cleaning products, cosmetics, and widely used in industrial productions, and only public outcry by consumers, not government regulation, is changing this potentially dangerous scenario. As stated, Triclosan is a chemical that is now found in a large percentage of soaps, toothpastes and household cleaning agents, despite the fact that the FDA proposed regulating the use of triclosan in 1972, and proposed eliminating triclosan as an active ingredient in hospital scrubs and hand soaps as far back as 1978. This was due to evidence that implied that triclosan can cause some bacteria to become resistant to antibiotics, as well as evidence that triclosan disrupts the thyroid hormone or alters the sexual steroid hormone metabolism in laboratory animals. In 1994, the FDA again proposed eliminating triclosan from hospital scrub and soap products, citing the very limited benefits of such long-lasting antibacterials over common short-acting antibacterial agents, such as alcohol, hydrogen peroxide and chlorine, and the potential harm in contributing to antibiotic resistance and harmful imbalance to the environmental biotic balance. In all of these instances, reviews of scientific data in response to industry objections were never completed.
In 2005, an FDA advisory panel finally stated that triclosan-laced soap was no better at preventing illness than plain soap and water. In response to citizen's complaints concerning public health and a lawsuit by the National Resources Defense Council, the FDA issued a statement in 2010 that the agency still did not have sufficient safety evidence to recommend changing consumer use of products that contained triclosan! Despite this, some manufacturers, fearing a closer public scrutiny, are removing the chemical voluntarily from their products. Colgate-Palmolive replaced triclosan in their antibacterial dish soaps and liquid softsoaps with lactic acid and other natural products, and other companies are doing the same to prevent consumer reactions against their products. Still, most consumers are not aware that the chemical, and other such antibacterial chemicals, are found in many products, including toothpaste, mouthwash, facial wash, and household cleaning products. A survey by the Centers for Disease Control and Prevention (CDC) found this chemical present in the urine of 75 percent of Americans over the age of 5! These facts were reported in the New York Times Business Day section of August 20, 2011. The FDA reports that they may finally complete the studies and reviews of the scientific data after nearly 40 years! This example of just one of the long-lasting antibacterial chemicals shows that our government is not responsive to public health when industrial profits and lobbying are involved. Lobbying by the citizens obviously needs to occur.
The seriousness of antibiotic resistant strains of virulent microbes is recognized by all governments and health authorities, yet the prescribing doctors and the public seem to downplay this health threat
The National Health Institutes (NIH) provides some understated data on the current antibiotic resistant microbe dilemma: http://www.niaid.nih.gov/topics/antimicrobialResistance/Understanding/Pages/healthIssue.aspx. The actual number of antibiotic resistant strains of microbial infection apply to many more common infections than these emphasized on the NIH website now. For instance, there is a significant prevalence of antibiotic resistance to the two most common bacterial middle ear infection agents. Gastrointestinal infections are increasing yearly in the United States and deaths from these infections have increased rapidly due to antibiotic resistance. The New York Times reported in a March 20, 2012 Science Times article entitled Gut Infections Are Growing More Lethal that deaths from gastrointestinal infections rose from 7,000 per year in 1999 to over 17,000 per year by 2007, and are still increasing, primarily due to the overuse of antibiotics, and the increasing antibiotic resistance to Clostridium difficile, which accounts for the great majority of these cases, as well as the destruction of the human biota by antibiotic overuse, and the loss of this valuable immune protection in our intestines. The destruction of the immune protections of the gut biota (symbiotic bacteria) have greatly accelerated the incidence of gastroenteritis due to the Norovirus as well, which now affects over 20 million patients per year in the United States. This Times article points out that antibiotic use acutely increases the risk of contracting gastroenteritis by 7 to 10 times, with this risk lasting for a month after discontinuing the antibiotic course. Risk for gastroenteritis continues to be tripled for months after completing the course of antibiotics.
This New York Times article also points out that many experts have stated that at least half of the antibiotics prescribed in the United States are unnecessary. Added to this is the common use of drugs that also break down natural gut immune protections and contribute to these bacterial infections, such as gastric acid inhibitors. In the March, 2012 issue of the Journal of the American Medical Association (JAMA. 2012 Mar 14;307(10):1014), research showed that the extreme rise in gastroenteritis related to Clostridium difficile bacteria was linked to use of gastric reflux drugs. These gastric acid inhibitors are now both routinely prescribed and generic, found on the drugstore shelf, without prescription. Studies by the pharmaceutical manufacturer, Pfizer, reported in 2007 that epidemiological studies identified an association between gastric acid suppressant drugs and Clostridium difficile colitis, as well as community-acquired pneumonia (Int J Infect Dis. 2007 Sep;11(5):417-22). These two problems have now become endemic to our hospitals and clinics, with about 94 percent of cases of C. difficile gastroenteritis occurring in hospitals, clinics and nursing homes where proton pump inhibitors are overprescribed. The growing problems of antibiotic overprescription and decreased health of the human biota and gastrointestinal function are affecting a large percentage of the population directly, and leading to an enormous death toll every year. By decreasing antibiotic overprescription and restoring the healthy function of our gastrointestial system with the aid of Complementary Medicine, we will greatly decrease this enormous public health problem. Individual patients may utilize Complementary Medicine, especially acupuncture and herbal/nutrient medicine, to restore the health of the biota and gastrointestinal system when they must take these antibiotics, decreasing the risks of acquiring community-based infections. Herbal medicine may also be utilized to treat mild bacterial infections, and should be adopted for viral infections, as antibiotics have no effect on viral infections.
To illustrate how far the industry has gone on overuse of antibiotics for profit, let us look at the case of Ciprofloxacin, commonly called Cipro, but which has over 300 marketed brand names worldwide to confuse the public. Ciprofloxacin is the most widely prescribed of the second generation of chemotoxic antibiotics called fluoroquinones, and is an antibacterial that doesn't just promote a stronger immune response, but actually kills bacteria by interfering with the enzymes that cause DNA to rewind after being copied, which stops synthesis of new DNA and of the proteins that are created by DNA and RNA. These effects are not limited to specific virulent bacteria, though, and affect not only nonvirulent beneficial bacteria, but also our own cells. Consequently, the FDA has had to issue the strongest warnings, called black box warnings, for this drug. Ciprofloxacin was only first approved by the FDA in 1987, and has just 12 approved human uses, and guidelines clearly state that this drug should be used only as a last resort to treat difficult bacterial infections. Since the drug generates more profit than other antibiotics, though, widespread prescription for minor infections, and numerous off-label uses have occurred. Ciprofloxacin was even promoted by the Bush administration after the strange anthrax scare occurred following 9/11. The administration approved the purchase of 100 million tablets of ciprofloxacin at about a dollar per pill from Bayer pharmaceuticals in 2002 alone, despite the fact that the drug normally used to treat anthrax was the much less expensive doxycycline. A full course of treatment for suspected anthrax exposure and prophylaxis cost the government $204 per person treated, compared to $12 per person treat with doxycycline. Not only was this enormous waste of money egregious to taxpayers, especially as the anthrax scare turned out to be a cruel hoax and manufactured terrorist threat, but the adverse effects of Ciprofloxacin, when the relatively benign and effective doxycycline was already proven effective, would add to the misery of patients treated for anthrax infection. Even in 1999, Cipro was the eleventh most prescribed drug in the United States based on new prescriptions, despite the FDA guidelines limiting its approved use. Clearly, most of this prescription of Cipro was made purely for profit, not for public health concern.
Not only Ciprofloxacin, but other common antibiotics, are eliciting FDA warnings in recent years as well. Zithromax, or Z-pac, commonly prescribed to treat bronchitis, pneumonia, and a host of other infections, received a strong new warning by the U.S. Food and Drug Administration (FDA) in 2013, with a significant incidence of heart disease linked to prescription of this antibiotic, increasing risk by 3-fold. This newer generation macrolide-type antibiotic Zithromax is commonly prescribed to treat strep throat, chronic bronchitis, tonsillitis, ear infection, sinusitis, skin infection, intestinal infection, venereal disease, cervical and urethral infection, and has common side effects of stomach upset, diarrhea, nausea, abdominal pain, hearing changes, blurred vision, muscle weakness, and liver problems, as well as tachycardia, irregular heartbeat, dizziness and fainting, and prolonged use comes with a warning that this frequently results in a candida or other yeast/fungal infection. Other newer generation antibiotics also come with a lower risk of causing heart disease, and while this risk is still relatively small, and does not preclude the use of these now common antibiotics for serious infections, obviously this adds new reasons to prescribe and use antibiotics only for real and serious, or threatening, bacterial infections. The use of antibiotics as a prophylactic measure whenever a potential bacterial infection occurs, when viral infection, or fungal infection occurs, when Lyme disease is suspected of causing a chronic syndrome, etc., is hopefully a consideration that of the past, as this practice has led to a global public health threat of antibiotic resistance. Risk versus benefit must now finally be taken seriously when prescribing.
As the threat of antibiotic-resistant bacterial infections mounts and spreads, the pharmaceutical industry is promoting more exotic antibiotic treatment strategies. The drug Zyvox (linezolid) is a reversible monoamine oxidase inhibitor (MAOI), which was a problematic type of antidepressant that is now little used. Zyvox is used to treat antibiotic-resistant Enterococcus, pneumonia, and skin infection. It works by inhibiting an enzyme that not only inhibits bacterial growth, but also the breakdown of serotonin in the brain. FDA warnings are now issued and are being investigated due to the number of cases of Serotonin syndrome attributed to use of the drug when taking other psychiatric and pain treating drugs that affect the serotonin system. More and more drugs that affect the serotonin system are now being prescribed for a wide variety of health problems, and Serotonin syndrome is a threatening disorder that occurs when too much serotonin builds up in the brain. Similar warnings have been issued for the drug Methylene blue, frequently prescribed for difficult low-grade urinary infections and urinary frequency in the combination called Prosed, and other anti-infectives. The search for synthetic drugs that treat antibiotic-resistant and difficult bacterial infections is leading us down a problematic path, whereas the long history of antibiotics developed in Nature's laboratory, seen in herbal medicine, is being ignored. In 2012, the pharmaceutical manufacturer of Zyvox agreed to pay the state of Oregon more than $3.3 million to settle claims that the company used false advertising and illegal marketing practices to promote Zyvox heavily in this state. The Oregon attorney general, John Kroger, found in a two year investigation that Pfizer used "unreliable and unsubstantiated claims" in marketing, as well as flawed clinical studies created by the company. This enormous state settlement builds upon a multistate settlement from 2009, as well as a federal fine of $2.3 billion. Oregon is using this money to fund a new program to educate consumers about antibiotic overuse.
The need to fast-track approval for new antibiotics has created tragedy across the globe, where pharmaceuticals have routinely been tested on desperate populations in Africa. Trovafloxacin mesylate (Trovan) is a broad spectrum quinolone antibiotic that works by blocking the activity of enzymes integral to the uncoiling and expression of DNA. In 1996, seeking a fast-track FDA approval for this new type of antibiotic, Pfizer pharmaceutical tested this drug on a large number of children during the worst meningitis epidemic in the history of sub-Saharan Africa. Parents of the children who died from the alleged controlled trial of Trovan without informed consent were able to finally sue in the United States courts in 2002, alleging that Pfizer violated the Nuremberg Code, Declaration of Helsinki, the International Covenant on Civil and Political Rights, and the law of nations by enrolling thousands of children in clinical trials during epidemics of bacterial meningitis, measles and cholera in Kano, Nigeria without real informed consent, and manipulated the study to create positive statistics. While the organization called Doctors Without Borders administered standard treatment during this crisis, Pfizer allegedly falsified documents from a non-existent ethics committee at the Kano Infectious Disease Hospital to obtain FDA approval to export the experimental antibiotic for the largest drug trial in history. Nigerian officials, acting in concert with Pfizer, allocated two wards of the Infectious Disease Hospital to randomly select children ages one to thirteen to receive either a standard antibiotic or Trovan to compare effects. The parents allege that Pfizer purposefully administered a low dose (one-third the usal dosage) of ceftiaxone to the control group to achieve more positive comparative study data, while the Doctors Without Borders in the rest of the hospital treated the children with the drug recommended by the World Health Organization, chloramphenicol. The parents of the children also allege that Pfizer tested the children's blood on entry and three days after starting treatment, and those children not responding to Trovan were switched to the control group. Eleven children died in this trial, and numerous children suffered serious and sometimes permanent adverse health effects. The drug was not tried on humans before this trial, but animal studies found that Trovan might cause joint disease, abnormal cartilage growth, and liver damage in children. Subsequently, the drug was denied FDA approval due to the significant risk of liver damage. This has become a prime example of the manipulation of human clinical trial data to provide "evidence-based medicine" that the American public and their prescribing medical doctors rely on. The floraquinolone Trovafloxacin was a fourth generation verison of Ciprofloxacin. The broad class of new antibiotics, only necessary due to the outrageous overuse of prior and safer antibiotics, seeks to inhibit bacterial expression by inhibiting various physiological mechanisms of DNA and RNA expression. While such drugs may be necessary as a last resort to save lives, the widespread use predicted for common infections needs to be examined by the public, and risks versus benefit more honestly considered.
More importantly, the public in the United States needs to examine its overall behavior and the behavior of the industries it supports, and effect positive changes to insure a better outcome for future generations. Part of this choice should include the awareness of traditional Complementary Medicine to utilize in promoting a healthy immune response to bacterial infections when appropriate. Even more importantly, the public needs to expand its awareness of appropriate treatment for viral, fungal and other non-bacterial infections. Antibiotics are not appropriate treatment for these non-bacterial infections. Herbal medicine has supplied evolved chemistry to help the organism defeat these non-bacterial infections for many centuries of human existence.
How antibiotic overuse hurts our own cells
The authors of the book Microcosmos (Lynn Margulis and Dorian Sagan) reveal that mitochondria, the organelles (small organs) found in most animal cells, that generate most of our ATP (adenosine triphosphate), or cellular fuel, via oxygen utilization, were derived from bacteria. The authors also state that mitochondrial ribosomes (DNA and RNA), as well as symbiotic bacteria, tend to be sensitive to exactly the same antibiotics as pathogenic bacteria. Streptomycin is an example of a common antibiotic that harms the cellular mitochondria and normal symbiotic bacteria in the body. For this reason, overuse of antibiotics creates problems with the health. Imbalance of gut flora and fauna, as well as of symbiotic bacteria in the mouth, vagina, and other tissues, can be negatively affected, and create chronic problems with one's health and immunity. Since mitochondrial dysfunction is now found to be at the heart of many diseases, especially chronic neurological diseases, and degenerative disorders, antibiotic use should be used only when necessary, and restoration of the gut flora and fauna, and strengthening of the immune system, should always be considered after using a course of antibiotics.
Another major concern in the last decade is the promotion of eosinophilia and eosinophilic infiltration to tissues and cells that are susceptible to damage by eosinophils, by various antibiotics, often compounded by the concurrent use of NSAIDS for inflammation and pain. Eosinophils are bone marrow-derived leukocytes, or specialized white blood cells, that are produced and activated under the control of various immune cytokines (IL-3, GN-CSF, IL-5), and usually make up only 1-6 percent of circulating white blood cells, or leukocytes. These specialized leukocytes are well known to attack various helminth parasites, such as giardias, to protect membranes in the body. They also have a diurnal pattern, with more produced in the peripheral tissues at night and early morning, when our endogenous corticosteroids are at their lowest. Low adrenal function, or adrenal stress is also associated with eosinophilia. These specialized white blood cells can easily attack the helminth, and other parasite, cells, but the process of destruction also makes eosinophils destructive to tissues and cells in the lungs, bronchioles, esophagus, stomach and other organs. To protect itself, the body normally creates barriers against eosinophil infiltration. When these barriers are breached, a host of eosinophil-related diseases occur, including asthma, COPD, esophagitis and gastritis. These are now called Hypereosinophilic syndromes (HES), which have been little studied and poorly understood. Worldwide, the number of diseases, including infectious, allergic, cancerous, primary hematologic disorders, and others, have been rising, but are not well-defined, according to experts at the U.S. NIH National Institute of Allergy and Infectious Diseases in a comprehensive report linked below in Additional Information. In the past, scientists considered this a problem mainly of helminth parasitic infection, but today we see an increasing prevalence, sometimes dramatic, in populations that are not infected by helminths, to the best of our knowledge. Various antibiotics are well known to cause eosinophilia, and are now also associated with migration of eosinophils to areas of the body where they destroy human cells when activated by various antigen and toxin triggers.
A 2007 report by Dr. Thomas B. Nutman M.D. of the U.S. National Institute of Allergy and Infectious Diseases noted that "medication-related drug reactions are perhaps the most common cause of persistently elevated eosinophil levels in areas where exposure to parasites is uncommon. Medication-associated peripheral blood eosinophilia may present without accompanying symptoms or may be associated with specific signs and symptoms. Asymptomatic eosinophilia has been associated most often with quinine, penicillins, cephalosporins (antibiotics), or quinolones (anti-bacterial antbiotic drugs used to treat urinary tract infections, but are broad spectrum). Pulmonary infiltrates with peripheral eosinophilia have been particularly associated with NSAIDS, sulfas (antibiotics and other drugs), and nitrofurantoin (antibiotic commonly used to treat urinary tract infections)." We see from this research that overuse of antibiotics are clearly linked to the degenerative damage to cells chiefly responsible for asthma, COPD, eosinophilic-related esophagitis and gastritis, which are increasing in prevalence dramatically, especially in children, but also in adults. This increase in prevalence of asthma and esophagitis in children mirrors the increased prescription of antibiotics and NSAIDs to children in the last 2 decades. COPD usually onsets later in life, but a childhood history of asthma increases the risk of acquiring COPD after age 40 tenfold.
The Long and Hidden Knowledge of Antibiotic Use contributing to Obesity
Perhaps the most alarming fact of the history of unnecessary overuse of antibiotics and ineffective prolonged courses of antibiotics with no real medical reason is the facts concerning antibiotics and weight gain. For decades, most of the antibiotics produced by the industry have been fed to our feed animals, not to treat bacterial infections, but because they upset the metabolic balance and cause profitable weight gain. In fact, it is now well established that the modern industrial feedlot technology came about due to the fact that feeding large amounts of antibiotics to the animals raised for our food both allowed large companies to crowd more animals in filthy living conditions without them getting sick, but also caused these poor animals to gain weight at amazing rates, and thus allowed these companies to feed them unhealthy diets and still produced more meat. Research into these alarming and cruel practices finally led to scientists wondering whether the amazing rise in obesity in the United States might be linked to overuse of antibiotics as well, especially the overuse of antibiotics in children.
A March 9, 2014 article in the New York Times, entitled The Fat Drug - How humankind unwittingly joined an experiment on antibiotics and weight gain finally reports on the obvious fact that we have known of the effects of antibiotics promoting obesity for decades, yet failed to protect our children from antibiotic overuse.
As the author, Pagan Kennedy, a recipient of a Smithsonian Fellowship for science writing and a 2010 Knight Science Journalism Fellow at MIT, details, any animal feed store today is stocked with bags of antibiotic powders advertised to dramatically boost the growth of poultry and livestock, but the disconnect between this and the dramatic scourge of obesity in the last few decades is amazing. Only recently has research been allowed to be printed concerning human weight gain and antibiotics. The history extends back to 1948, when a biochemist named Thomas H. Jukes discovered that a new antibiotic, Aureomycin, dramatically increased weight gain in study animals, doubling the weight gain over controls. This researcher then used the waste material being thrown away in manufacture to conduct more experiments showing that amazing potential of this antibiotic to speed the growth of all types of feed animals. The pharmaceutical companies promoted the fact that these antibiotics would have weight gain as a side effect as a positive factor, staging competitions in 1955 to see who could gain the most weight from consuming antibiotics. Only one scientist on record at the time wrote that this may be a negative health effect. Alexander Fleming, a Scottish biologist who discovered penicillin, was visiting the University of Minnesota at the time and heard of weight gain as a positive effect of consuming antibiotics, and remarked: "I can't predict that feeding penicillin to babies will do society much good. Making people larger might do more harm than good." In reaction, scientists created experiments where they fed antibiotics daily to schoolchildren in Guatemala and elsewhere for more than a year and measured there weight gain. A doctor in Florida won approval to conduct this experiment on retarded children. It turned out that almost all antibiotics could affect the metabolism and cause weight gain, with yearly gain in these children averaging 6.5 pounds, compared to the normal growth in controls of 1.9 pounds. The military used antibiotics to see if they could spur more growth in recruits undergoing basic training. Apparently, the idea that altering the metabolic functions of humans and animals with overuse of antibiotics should not even be questioned.
In the last few decades, as the proof and warnings of antibiotic resistant strains of bacteria mounted, the prescription of antibiotics increased in children to the point where multiple courses of antibiotics per year were now the norm. Martin J. Blaser, the director of the Human Microbiome Program at New York University, and a scientist at the U.S. Centers for Disease Control and Prevention, began to study these negative health effects in the 1980s. He found that mice given a high calorie diet in the laboratory who were also given an antibiotic gained about twice the weight in their obesity as the controls who were fed a high calorie diet without antibiotics, and that females were affected much more than males. The weight gain was mostly in fat cells. Dr. Blaser had shown that sugar and simple carbs alone were not causing the scourge of obesity, which was just starting in the U.S. He warned that antibiotic overuse was contributing to this epidemic of obesity. He also found that besides altering the metabolism, that these courses of antibiotics were more destructive of the symbiotic gut biome than had been suspected. Certain antibiotics, such as Ciprofloxacin, in fact have been shown to completely eradicate important species of symbiotic bacteria in some patient's intestines, bacteria that they may have been born with, and were essential to their health. Only in recent years have we developed the technology to trace this complex biome in the human, with many thousands of species, and many important symbiotic effects, supplying the host with nutrient chemicals, as well as providing a strong immune function to control overgrowth of pathogenic microbes. Even with these studies, medical doctors are not significantly considering these risks in their prescription habits. The disconnect is profound.
What has standard medicine taken away from all of these findings? Instead of feeling ashamed and worried about this scenario, the standard medical industry now sees the potential to develop a whole new line of chemicals designed to alter the human biome to treat obesity, cancers and other diseases. Instead of seeing the need to preserve the evolved homeostasis of the biome as much as possible, or restore it naturally, the expensive and perhaps problematic path of introducing allopathic designer microbes to treat disease is being engineered. The problem is that the field of microbes in the human biome is a large quantum field of balanced interactions, and simply introducing a few specific designer microbes into this field is sure to cause imbalances and side effects. While this tactic will be useful, ignoring the need to just stop destroying the human biome with medicines, and working to utilize Complementary Medicine to help patients restore homeostatic function and balance in their biome, will once again be ignored. The answer to the question of why is that there is obviously little profit to be had in these tactics, and it could in fact hurt the bottom line. When the public can finally convince the medical industry that profits should not be the main motivating and guiding force in the field of medicine, we will all be able to give a sigh of relief. In the meantime, informed and intelligent patients should be worried.
Antiobiotic Facts and a History of Warnings
- An antibiotic is a substance derived from a bacterium or mold that inhibits the growth of other bacteria or microorganisms. Antibiotics have no effect on viruses or fungal infections. There are at least 10 types of antibiotics, and specific antibiotics are often needed to inhibit specific bacteria or other living pathogens. Within these types are hundreds of variations, and hence a wide variety of brand names, but traits of antibiotic resistance usually apply to a type of antibiotic, not just each variant. Common antibiotics are 'broad-spectrum', meaning that they may inhibit a variety of bacteria, but may not be effective for a specific bacterial infection. A simple culture, or sample, is taken and analyzed to make sure that the right antibiotic is matched to your infection. In 2012, the University of California at Davis set up a free database of over 100,000 types of bacteria commonly found in food, with genetic mapping, showing the complexity of potential gastrointestinal bacterial infections. Many common pathogenic bacteria have large number of strains, such as salmonella, with 2700 known strains discovered with genetic mapping. A 2001 meta-analysis of the standard protocol of prescribing antibiotics for viral bronchitis by the Cochrane medical database showed little benefit in clinical studies, limited to affecting concurrent bacterial infections. This review can be accessed at: http://www.aafp.org/afp/20010701/cochrane.html. Use of the right antibiotic, for the right amount of time, and possibly combined with the synergistic effects of broadly effective herbal antibacterial and antimicrobial chemicals, may be the protocol of the future, to both increase effectiveness for the patient and to minimize the risk of increasing drug-resistant strains in the individual and in the overall population.
- Fluoroquinolones are antibiotics that produce adverse events and come with stronger warnings than any other class of antibiotics. In most cases, these adverse health events are mild to moderate, but black box warnings have been added to quinolone antibiotics regarding peripheral neuropathies, tendon damage (achilles tendon ruptures), heart problems (arrhythmias), colitis, accumulation of protein fragments leading to muscle degeneration, and negative interactions with ibuprofen and other NSAIDS. A 2007 FDA warning was added that stated: "Other serious and sometimes fatal events, some due to hypersensitivity, and some due to uncertain etiology, have been reported in patients receiving therapy with quinolones, including ciprofloxacin." Some of these serious events include liver failure or inflammation (hepatitis), Clostridium deficile associated disease, and pseudomembranous colitis. Other serious adverse events reported include bone marrow suppression (immunodeficiency and anemia), loss of vision, involuntary muscle movements (choreas), and eosinophilia (muscle pain, myofascial pain, neuropathy, paresthesias, fatigue, arrhythmias, short term memory loss, neuralgia, chronic fatigue syndrome, depression, scleroderma-like syndrome). When eosinophilia-myalgia syndrome affected three children in 1999 after consuming a supplement of L-tryptophan amino acid that was bacterially contaminated, all L-tryptophan sales were halted while the FDA investigated for about 10 years, but quinolone antibiotic prescription was hardly affected by incidence of eosinophilia linked to this antibiotic. Association of eosinophilia with ciprofloxacin use dates back to at least 1989 (Am J Med. 1989 Nov:87(5);589-90). In 2016, the U.S. FDA announced stronger warnings once again: "The U.S. Food and Drug Administration is advising that the serious side effects associated with fluoroquinolone antibacterial drugs generally outweigh the benefits for patients with acute sinusitis, acute bronchitis, and uncomplicated urinary tract infections who have other treatment options. For patients with these conditions, fluoroquinolones should be reserved for those who do not have alternative treatment options." New concerns listed include pins and needles peripheral neuropathy, tendon and joint pain, and confusion with hallucinations.
- Sulfa drugs are called 'antibiotic' but are actually synthetic drugs, like fluoroquinones, that compete with bacteria for enzymes needed for the bacteria to reproduce. The first sulpha drugs were called chemotherapy and were used to treat bacterial pneumonia. These drugs have many side effects and many people are thus 'allergic' to them. These side effects include anemia, urinary tract disorders, skin rash, neuropathy, nausea, anxiety, fast heart rate (tachycardia), constipation, and other autonomic disorders. Drugs such as sulfa drugs and fluoroquinones affect all cells, not just those of the virulent strains of bacteria for which they are prescribed. These drugs affect the expression of DNA and protein expression, and the many dangerous side effects reported are explained by their physiological actions.
- Studies for the last 30 years have shown that antibiotics have little or no effect after 8-12 days in general, but overprescription decreases the effectiveness of the antibiotic for over 12 weeks, and increases the risk of drug-resistant strains. A study published in the British Medical Journal of 119 children hospitalized with acute respiratory infection showed that administration of amoxicillin more than tripled the average minimum inhibitory concentration effectiveness for the antibiotic, and more than doubled the incidence of drug-resistant strains of the bacteria in the patient, with effects lasting more than 3 months. This study can be seen at: http://www.bmj.com/cgi/content/abstract/335/7617/429, or by researching the BMJ 2007;335(7617:429(1 September) doi:10.1136/bmj.39274.647465.BE, (published 26, July, 2007)
- Overuse of antibiotics taken orally will upset the symbiotic bacterial balance of the digestive tract, often causing overgrowth of fungi such as candida, as well as depleting many beneficial bacteria that produce necessary vitamins and other nutrients in our bodies. Overuse may also cause depletion of symbiotic bacteria in the urinary tract and vagina, causing urinary tract infections and yeast infections. Dangerous bacterial infections of the GI tract are also on the rise, such as Clostridium difficile infections that now bring nearly 400,000 patients to acute care facilities, and these are largely attributed to overuse of antibiotics, which temporarily wipe out the healthy bacteria in our digestive tracts and leave us more vulnerable to community infections. The majority of the antibiotics manufactured in the United States are now used in feedlot animals, mainly to produce rapid growth rates, and while these antibiotics may not survive in significant concentration in the meat that is eaten, an enormous amount is excreted by the animals, with these antibiotics pouring into the nation's water. Antibiotics and the ability to disrupt the neurohormonal metabolism and spur growth is now being researched and linked to obesity and cancer. Read about this threat to public health in the New York Times, Science Times, by clicking on this web address: http://www.nytimes.com/2009/04/14/health/14well.html?em
- Antibiotics do have side effects. Beside allergic reactions, antibiotics are known to cause nausea, diarrhea, dizziness, tinnitus, and liver or kidney damage. Adverse effects on the central nervous system, cartilage damage, DNA damage, and formation of urinary and kidney stones have been increasingly studied in recent years. Use of concurrent antacid medications with fluoroquinolones has been a clinical concern. These studied adverse effects are mainly the acute effects, and finally, the chronic adverse effects of overuse of antibiotics is being studied, with alarming data linking this practice to obesity, cancer and neurohormonal disease.
- A study with mice showed that doxycycline antibiotic could 'switch on' a gene called DMPK, causing overexpression of this gene resulting in irregular heartbeat, slow muscle wasting, insulin resistance and cataracts, as well as the inability to relax muscles. (Nature Genetics DOI:10.1038/ng1857, Sept 2006). The increase in incidence of insulin resistance diabetes or metabolic disorder may be linked to overuse of antibiotics to some extent. There has been a large disincentive to research these long-term adverse effects due to a mantra that discouragement of antibiotic use of any kind will create problems in control of infectious disease. Obviously, the issue of antibiotic use is not a binary right or wrong issue, but a nuanced one, and the consequences of the wrong antibiotic protocol are becoming apparent.
- Certain antibiotics have been associated with sudden tissue ruptures in tendons. The New York Times Sports Magazine, Sept. 2008, reports in an article on sports injury to the feet, that a course of Ciprofloxacin, or levofloxacin, a fluoroquinolone class antibiotic, was probably linked to a plantar fascia tear that ended the competition for a triathlete being interviewed. A study published in the British Journal Diabetic Medicine, Vol23, Dec2006, confirms the association of tendon rupture with Cipro use and discusses the pathology. Although quinolone-induced tendonopathy was noted as early as 1983, the FDA did not issue a warning until 1996, because medical doctors are reluctant to cite antibiotic use as a probable cause, resulting in severe under-reporting. Studies have implicated ischemic, toxic and matrix-degrading processes as the mechanisms involved, and implicated concurrent use of steroid therapies, diabetes, hormonal imbalances, magnesium deficiency, diuretic use and prior tendon pathology as potential cofactors. Researchers and doctors at the Mount Sinai Medical Center concluded that "With the increasing use of levofloxacin and other quinolone antibiotics, we should expect to encounter a growing number of patients experiencing tendonopathy." (The Journal of the Am Board of Family Practice 16:458-460, 2003). A September 10, 2012 article in the New York Times, entitled Popular Antibiotics May Carry Serious Side Effects, outlines the current worldwide concern for overprescription of fluoroquinolones: click here to read this article: http://well.blogs.nytimes.com/2012/09/10/popular-antibiotics-may-carry-serious-side-effects/.
- Quinolone antibiotics (Cipro, Levaquin, Floxin, Tequin, Avelox, Factive, Noroxin) have been long noted for causing various neuropathies (Annals of Pharmacotherapy Dec 2001 Cohen), and in 2004, the FDA mandated new warnings on labels of quinolone antibiotics concerning peripheral neuropathies affecting both large and small nerve axons. In 2005, the Physicians Desk Reference (PDR) increased warnings that quinolone antibiotics may cause dizziness, confusion, tremors, hallucinations, depression, restlessness, anxiety, lightheadedness, paranoia, insomnia, nightmares, and increased risk of seizures. Other warnings include tendon ruptures and arrhythmias. Despite these risks of adverse events and serious health threats, the prescription of quinolone antibiotics has not been significantly reduced. Dr. Jay Cohen, a noted researcher of medication reactions, posts a website that provides documentation. Click here to link: http://www.medicationsense.com/articles/may_aug_05/warning_antibiotics_052205.html.
- Despite clinical reports linking antibiotic use to osteopenia and osteoporosis, there have been very few studies of this risk in the United States, but a number of highly publicized studies designed to deter this concern. Studies have shown that in some patients a very low dose of tetracyline used with estrogens may have shown some improvement in osteopenia. The concern with osteopenia lies mainly with the use of quinolone antibiotics, though, not these standard antibiotics like tetracycline, and the physiological mechanisms by which these quinolone antibiotics cause tendon rupture and jaw bone degeneration are still being explored. Outside of the United States, the medical community has largely concluded that there is a strong link between certain types of antibiotic, especially those that induce cytotoxicity and oxidative damage in bone cells, or osteoblasts. A number of studies (some cited below) show that specific herbal chemicals, such as honokiol in Magnolia officianalis (Hou pou), Glabridin, and Kaemperferol, may significantly protect against such osteoporotic degeneration.
- The importance of the intestinal biota, which is individualized in content and contains thousands of microbial strains that are symbiotic and important to human health, has been now been thoroughly affirmed in numerous scientific studies. In fact, a controlled human clinical trial in 2013 confirmed that fecal biotic transplants (transplanting the feces and biota from a healthy individual with the same biota type to another individual) is an effective cure for antibiotic-resistant Clostridium difficile infections, and may soon be utilized routinely in hospitals to save lives. Fecal biota transplants have also been proven effective to treat a variety of serious chronic diseases, and larger placebo-controlled randomized human clinical trials are being created to provide proof of efficacy for the future. The cost of a fecal biota transplant is minimal compared to the cost of standard treatment for many of these diseases. Hopefully, the medical industry will not block utilization of this inexpensive treatment like they have blocked the use of inexpensive Complementary Medicine for so many decades. The consumer and taxpayer pays for this blocking of less expensive but effective therapies. In response to research that implicates the destruction of the human biota in many common diseases, as this complex symbiotic microbial organism not only protects us as a first-line immune defense, but also supplies essential nutrient molecules to its human host as needed, the pharmaceutical industry is proposing not guidelines to reduce pharmacological harm to the biota, but the introduction of expensive new designer bacteria to treat disease in patients with this damaged biota. Whether the public will finally see the problems with this type of strategy will be seen. As the increasing adverse effects of new drugs are repeated in manipulative advertising campaigns, the public is brainwashed into an attitude of unconcern. If this happens in genetically designed microbes, further upsetting the evolved and complex balance of symbiotic microbial life in our bodies, the consequences for the future may be devastating.
To be safe and minimize the risks to yourself, as well as to preserve public health for the future and stop the spread of antibiotic-resistant strains of bacteria, you should take antibiotics only when necessary and appropriate, and generally in short courses of less than 10 days. This means that you should generally not take antibiotics for viral illnesses such as the flu, common cold and viral lung infection. If the illness lingers, there is a possibility that a bacterial infection has occurred due to the inflamed tissue from the viral illness. In this case, a short course of antibiotics might be beneficial.
While it is tempting for the patient to jump to conclusions that persistent infections are the result of taking too short of a course of antibiotics, the real physiological story is usually much more complicated. There may be more than one strain of bacteria involved, and the antibiotic has helped to clear only some of the infectious strains of bacteria. There also may be a concurrent bacterial and viral infection, and symptoms of the bacteria infection may be cleared with proper antibiotics, but not the viral aspects. When the virulent bacterial strain is antibiotic resistant in the intestines, use of antibiotics will kill the beneficial symbiotic bacteria instead of the virulent strain, and these symbiotic bacteria are an important protection our bodies utilize to control intestinal infections and bacterial overgrowths, as well as to reduce the toxins produced by virulent bacteria. Using standard antibiotics in these cases hurts, rather than helps, our abilities to fight the infection. Utilizing professionally prescribed herbal formulas, on the other hand, may help fight these infections in a number of ways.
To illustrate the lack of a sound medical protocol regarding bacterial infections we may look at the response to the E. coli outbreak in Germany in May of 2011. A particular strain of bacteria, such as E. coli, has a very large number of variants, or mutations, that our immune defenses are not prepared for. E. coli strains are symbiotic and beneficial in our gastrointestinal tract as well, but when a new variant such as this one emerges it may cause a severe acute inflammatory immune reaction. Public health authorities reported that this strain of E. coli was antibiotic resistant, revealing how common strains of bacteria unseen before are mutating as usual, but that these new mutations may be inherently antibiotic resistant due to the past overuse of antibiotics and the large number of bacteria evolving a protective resistance to antibiotics. Health authorities surmise that the new strain of E. coli was exposed to a large amount of antibiotics from the waste from animal feedlots where animals were given large amounts of antibiotics to promote growth. The antibiotics in the wastewater containing feces and urine affects vegetable crops and the bacteria that normally grow on these crops or in the soil. Despite the apparent antibiotic resistance of this strain of E. coli, the patient's medical doctors used one after another antibiotic to try to treat their patients. Even with all of our medical and public health knowledge, standard treatment is still persistently pursued that is wrong and harmful, and standard use of antibiotics as growth promoters in our meat producing industry will continue, unless the public voices objection. In 2012, such public objection resulted in a Federal Judge ruling that the FDA must finally enforce its 1977 ruling that antibiotics in animal feed presents a serious public health threat. Due to large amounts of lobbying this protection of public health has never been enforced.
U.S. public health authorities heavily criticized the response of standard medical practitioners to this E. coli infection in Germany in 2011. Despite the apparent antibiotic resistance, medical doctors in Europe used a number of antibiotics in succession to treat these patients.
Dr. Phillip Tarr, a professor at Washington State University responded in the New York Times: "If you give antibiotics and the strain is resistant, then you give that bacteria a competitive advantage to the other bugs in your gut that are susceptible to drugs, an so it's an even better environment for the infection."
In other words, when an apparent bacterial infection does not respond immediately to antibiotics, continuing to take antibiotics will make the infection in the intestines worse. This is because our normal immune protections include the action of symbiotic bacteria to control adverse bacterial growth in the intestines. A number of patients affected by this food-borne bacterial infection died, and the cause of death was the body's response to a disseminated toxin in the blood circulation released by this strain of bacteria. The small blood vessels, or arterioles, became obstructed with clots that the body creates to protect them against the toxic vascular inflammation, and in some patients, this overwhelms the circulation and the patient dies of kidney or other organ failure. The standard recommended treatment protocol should be to avoid antibiotics and to provide the right amount of intravenous fluids until the immune system can control the infection. Integrating herbal medicine into this protocol could also be highly beneficial and save lives, yet it is stubbornly avoided.
The patient that wants to take a more proactive approach with infections may want to let the medical experts explain the facts better rather than jumping to simplified conclusions. A patient wanting to take a more proactive role may inquire about specific testing and identification of the strains of bacteria so that the most specific antibiotics are used, and discuss choices in a reasonable course of the antibiotic that is individualized rather than a one-size-fits-all approach, to minimize overuse. A patient may also take a more proactive approach by consulting a professional herbalist, such as a Licensed Acupuncturist, and take herbs to complement the antibiotic effects, as well as to provide antiviral effects not available in prescription drugs. Herbal medicine may also promote faster tissue healing, antioxidant effects to clear the debris when infection is clearing, and also to potentially prevent or treat the side effects of antibiotics.
Many herbs have strong antibiotic, antifungal and antiviral chemicals in them. Use of herbs to treat these infections is usually effective. Studies have shown that many herbal chemicals also potentiate the antibiotic pharmaceutical meds for greater effect. Herbal prescription is an effective alternative or complement to antibiotic use. Since certain herbs are also effective for certain infections, you should consult a professional to insure good results. The Licensed Acupuncturist is usually a well trained herbologist.
Lastly, the overuse of antibiotics by the meat producing industry is also a huge threat to public health, as evidenced by the NY Times article cited above. These antibiotics may linger in the meat tissue when eaten, overuse has spurred high incidence of antibiotic-resistant bacterial strains in these meat animals, and antibiotics are being dumped as waste into the waterways, consumed by animals in the wild as well as humans who drink this water. In addition, the antibiotics and antibiotic-resistant bacteria are contaminating plant crops as the fecal and urinary waste is both contaminating the waters and used as fertilizer. This is causing many health problems with the wild animal population and certain human populations. You may help stop this problem by eating only animal products, meat and dairy, that specify that antibiotics are not used, or by eating only local organic meat and dairy products. Range fed beef need very little antibiotic use and are helping to restore the environment of our grasslands. You may also protest this problem of antibiotic overuse by corporate feedlots to your congressman or senator to spur legislation to stop this unhealthy practice. Or you could minimize your meat consumption, which too is a popular health protocol that is proven to benefit overall health as well as prevent a host of serious problems. Many people are now consuming more fish and less beef to improve health, but this increased demand has spurred the industry to create massive fish farms that also utilize antibiotic overuse, as well as spread disease to the wild fish in our oceans that has probably decimated the Pacific salmon population. The concerned person will learn the facts and do what they can to counter this enormous problem. A food industry purely concerned with profit will not protect the public health.
Antibiotic resistant strains of bacteria and adjunct herbal medicines
Overuse of antibiotics has created a health crisis affecting not only most hospitals, but now extending to the general population. The most publicized strain is referred to as MRSA, or methycillin-resistant staph aureus, but today almost all types of virulent bacteria have developed not only antibiotic resistant genetic traits, but resistance to other types of drugs as well. In 2012, the ECDC (European Centre for Disease Prevention and Control) and the U.S. CDC proposed the terms MDR (multi-drug resistant), XDR (extensively drug resistant) and PDR (pan-drug resistant) to classify data, especially for the now ubiquitous drug-resistant strains of Staphylococcus aureus, Enterococcus, Enterobacteriaciae, Pseudomonus aeruginosa, and Acinetobacter that are most often a threat in the hospital settings around the world. Staphyloccus is a common strain of gram-negative bacteria that is always on our skin and membranes, but is involved in serious infections when it is not kept in check by the balance of bacteria, and by our immune systems. A number of Chinese herbs have already been identified as effective in countering MRSA, including Scutellaria barbata, or Ban zhi lian (Ethnopharmacology, 2000:72;483-488). The most studied active chemical in this herb is apigenin, which is also found in other Chinese herbs, such as Cassia occidentalis (Wang jiang nan seeds), and Selaginella tamarisina (Juan bai).
A 2000 study by the Robert Gordon University School of Pharmacy, in Aberdeen, UK, found that the common Chinese herb Scutellaria baicalensis (Huang qin), or the variant Scutellaria amoena, containing the active chemical baicalin, was effective in potentiating antibiotics against MRSA and beta-lactam-resistant Staph aureus, and in fact had the capability to restore the effectiveness of beta-lactam antibiotics against MRSA. A link to this study published in the Journal of Pharmaceutical Phamrmacology 2000 March;52(3):31-6, and posted on the NIH PubMed website (PMID: 10757427) is available by clicking here: http://www.ncbi.nlm.nih.gov/sites/entrez. This herb does act in a dose-dependant manner, and use should be supervised and guided by a professional for effectiveness, although the herb is much used, nontoxic, without contraindications in combination with pharmaceuticals, and very safe. In Traditional Chinese Medicine (TCM), this herb is often used in a formula to increase effectiveness. Quality of the herb or herbal product is also very important, and the patient should rely on a professional herbalist and professional products, or even the raw herb decocted or in tincture, to insure that they are taking an effective version of the herb, as well as guidance with dosage.
Other herbs that have been studied and proven effective against MRSA include Turnera ulmifolia (ramgoat dashalong, a Brazilian herb) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2685411, and research from China is expected to reveal a wealth of herbs and herbal strategies soon. Herbal formulas also are studied and found effective at promoting immune mechanisms to aid in treatment of resistant strains of bacteria. Such herbs as astragalus are well documented in this regard, and work by stimulating the inherent immune responses.
A wide variety of bacterial strains have developed antibiotic and drug resistance by 2010. The mechanisms of resistance usually involve either a binding protein inhibition or a chemical that inhibits the antibiotic itself, and thus a number of different types of antibiotic might be ineffective for a particular strain of antibiotic resistant bacteria. Viral infection remedies have also seen a quick adaptation to drug resistance, as well as some other common microbes, including candida fungi. The NIH has this short public website announcement: http://www.niaid.nih.gov/topics/antimicrobialResistance/Understanding/Pages/quickFacts.aspx
The American Society for Microbiology now lists herbs that are confirmed in scientific study to contain antimicrobial activity. This list can be reviewed by clicking here: http:/cmr.asm.org/cgi/content/full/12/4/564/T1. In this list, which is still partial, since published scientific study of herbal medicine is a recent phenomena in the U.S. and Europe, a number of commonly prescribed herbs in TCM, as well as a number of commonly used native American herbal remedies are shown to have potent antibiotic effects. Even a number of common foods have been shown to have modest antimicrobial activity. Degree of toxicity is noted, as well as reference citations, but the degree of effectiveness is not listed here, and one needs to reference the actual studies, often listed now on PubMed database, or refer to phytochemical textbooks or databases, which the professional herbalist utilizes in practice.
Many threatening types of virulent bacteria have evolved antibiotic resistance today, and we now know that these resistant traits are passed on to other bacteria by way of capsids and viruses, ways that bacterial species have evolved to communicate genetic data. One such threatening infection is Tuberculosis, a disease usually caused by the bacterium Mycobacterium tuberculosis, usually affecting the lung, but also able to infect any part or the human body, especially the kidneys, brain, and spine, and at times has been the leading cause of death worldwide. Some countries, such as Vietnam, were hit particularly hard by TB, and with improved access to specific antibiotics, such as Isoniazid, Rifampin and Rifapentine, as well as vaccines, the rates of infection and mortality were dramatically lowered, but today, with the rise of antibiotic resistant strains of the bacteria TB has returned as a major health threat, expected to kill at least 1.5 million in 2016 worldwide. Drug resistance occurs especially when the patients do not take a complete course of the antibiotics, when the drugs are not of high quality, and when patients have a recurrence or second infection of TB, but can also occur when TB is prevalent, and the bacteria pass on the genetic traits in the bacterial colony. Treatment of the known types of drug resistant TB, MDR (multi-drug resistant) and XDR (extensively drug resistant), are very prolonged, costly and come with dramatic adverse health effects, potentially life-threatening. Fatigue, muscle weakness, peripheral neuropathy, confusion, seizures, blurred vision, liver dysfunction, jaundice, nausea and abdominal pain are common adverse effects.
Herbal medicine has been well studied and found to potentiate the antibiotics, prevent TB or recurrence, treat drug resistant strains of TB, and alleviate the adverse health effects of standard treatment, with very little risk of contraindication or negative drug-herb interactions. Nevertheless, integration of herbal medicine and TCM therapy has been widely discouraged by medical doctors. Early meta-reviews of integration of herbal medicines in TB care of course stated that there was not definitive proof of effectiveness despite widespread use in Asia, but came with the note that standard randomized controlled clinical human studies presented difficulties in evaluating herbal medicines, resulting in low quality of studies. By 2011, with the alarming rise in drug-resistant TB strains, large studies by standard university medical schools started providing proof and recommendation of specific herbal chemicals that were proven effective, including curcumin, from Curcuma longa and zedoaria (Jiang huang and E zhu), as well as sesquiterpenes from Celastra vulcanicola (Lei gong teng, commonly called Trypterygium wilfordii, or analogous to C. orbiculatus, Nan she teng), lignans from Aristolochia taliscana (analogous to Mu tong, and Ma dou ling), essential oils from Myrrh communus (Mo yao), extracts from dried Aloe vera, and chemicals in Tinospora cordifolia (Kuan jin teng). To see this meta-review by experts at the SRK Institute of Applied Science, in India, click here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262386/ . These are just some of the many herbal and other therapies that will soon be studied and proven to help when integrated into care once the industry bias is overcome. A 2015 meta-review of all published RCTs of integration of Chinese Herbal Medicine (CHM) in the care of drug-resistant TB by experts at the Tongi University School of Medicine, in Shanghai, China, found that even with the reluctance to publish or conduct such studies that this combination showed superiority in treatment success and measurable outcomes with radiology, as well as fewer adverse effects of treatment. To see this study, click here: http://www.ncbi.nlm.nih.gov/pubmed/26275647 . Of course, dosage of specific herbal extracts are important in the effects, as well as quality assurance, but even standard low dosage in common formulas could benefit therapy when integrated, with little or no risk of adverse health effects.
Ways to improve the human immune system to provide better protection against bacterial virulence and infection
We now know that bacteria are actually a significant part of the human organism, with the symbiotic bacterial and microbial Biome necessary for human health, and with more bacterial cells in the human body than actual human cells, supplying us with a vast array of necessary chemicals to insure our health, as well as providing the first line of immune defense against threatening bacterial, fungal, viral and parasitic disease. Simplifying the medical approach to infection as a war against all bacteria and other microbes is ridiculous, and unscientific, and belongs to a past era where we didn't know better. Today, we need to understand how to build better immune defenses to prevent and treat these bacterial infections and diseases. Dumbing down this issue has created a public health disaster.
The innate immune system plays an important role in protection against pathogenic bacterial disease, and in distinguishing beneficial bacteria from pathogenic types. This innate immune system inherited in our genetic code works with the adaptive immune system, which continues to learn new ways to achieve this complex task of differentiating and countering pathogenic bacteria. We can improve the innate immune function and help this adaptive immune system by using traditional medical strategies that are supported by current scientific research. We know that key aspects of the innate immune system, such as the Toll-like receptors (TLRs), nucleotide-binding oligomerization domains proteins (NOD-like receptors and NLRs), regulation and production of new healthy leukocytes such as lymphocytes, and membrane antibody regulation play key roles in host protection against bacterial and microbial pathogens, as well as in healthy homeostasis of the Biome. These keys to an intelligent complement immune response can be helped with CIM/TCM, and do not solely depend on new pharmaceuticals to improve immune responses. The study of cell receptors that initiate and regulate the initial immune responses to pathogenic bacteria, such as the TLRs and NLRs, have shown that a quantum field of chemicals and cell receptors are involved in complex responses, and allopathically altering just one aspect of this field of effects will have very limited benefits. Lectins, both created by the human host and the microbes that enter the host and are symbiotic with the host, play a key role in this complex complement initial immune response. Research is now showing that an array of herbal and nutrient chemicals work against pathogenic disease by regulating expression of these cell receptors and improving normal homeostatic functions of the human innate immune system. Acupuncture is shown to work symbiotically with these herbal chemicals to improve these responses, and specific nutrient medicines are proven to help improve the homeostasis related to lectins and lectin responses. Instead of looking for a simplistic single answer to how CIM/TCM works, we need to look at the big picture and complexity of how Complementary and Integrative Medicine provides a field of safe and beneficial effects, that when combined in a more intelligent treatment protocol provides the array of holistic effects that we actually need. This is how holistic medicine works, yet we still see the deluded search for the single herb or herbal chemical that provides some sort of miraculous allopathic effect, and this search is generated by a lot of advertising and misinformation on the internet, and by standard medicine itself.
So much current scientific study of herbal medicines is now available that proves that traditional herbal medicines affect these specific key aspects of the innate immune responses against bacterial pathogens that it is overwhelming. Some of the key Chinese herbs studied in relation to infectious disease and immune function that are proven to regulate the immune cytokines that control the balance between anti-inflammatory and pro-inflammatory responses are shown to achieve this helpful immune modulation via the regulation of expression of these key innate immune system cell receptors. For instance, in 2015, research in China showed that the much studied Chinese herb Trypterygium wilfordii, or Lei gong teng, has a dose-dependent effect inhibiting pro-inflammatory cytokines such as TNF-alpha and IL-1beta, and downregulating expression of NK-kB by its ability to downregulate expression of TLR4 and NF-kB p65 cell receptor expressions (PMID: 26790303). A 2014 study at the Nanjing Medical University, in Nanjing, China, and the Anhui Medical University, in Hefei, China, showed that the most common immune modulating Chinese herb, Astragalus (Huang qi), regulates TLR4-mediated signals of dendritic cells (antigen-presenting cells of the immune system) to restrain stomach cancer (PMID: 25371568). Such study shows that chemicals in Chinese herbs help improve the complex complement effects that coordinate the innate and adaptive immune systems, and the T-cell responses. These activities are not confined to stomach cancer, but are broad effects evolved to help the human organism work better, and survive. Also in 2014, studies at the Sunghyunkwan University School of Phamacy, in Suwon, South Korea, showed that the common Chinese herb used in anti-bacterial formulas, Lonicera Japonica (Jin yin hua), here termed HS-23, treats sepsis in infections via suppression of the TLR signaling pathways. To see this study, click here: http://www.ncbi.nlm.nih.gov/pubmed/24862492 . This common Chinese herb is the basis for the much used formula Yin Qiao San, used to treat or prevent the flu, but this study shows that broad application of the herbal extract, either in various formulas at a low dosage, or used by itself in a higher dosage.
Neutrophils are white blood cells, or leukocytes, that are a key component of the innate immune system, and a critical link between the innate and adaptive immune responses. The first line of defense against bacterial infections involves the neutrophils, and the vast majority of the neutrophil reserves in the body are found in the secondary lymphatic organ, the bone marrow, which has a rich vascular supply and can quickly deliver these leukocytes when needed. Neutrophils are generated in the human body at a rate of 100 billion to 200 billion per day, and only about 1-2 percent are normally in circulation. When we experience a bacterial infection billions of neutrophils may be released from the bone marrow to counter the infection. Herbal medicine and acupuncture has been shown to help the bone marrow achieve better function and potential, along with exercise, healthy diet and decreased stress. Even gentle herbs are shown to provide benefit activating circulating neutrophils. For example, a 2015 study at the Chang Gung University of Science and Technology, in Taoyuan, Taiwan, showed that the common Chinese herb Perilla frutescens leaf (Zi su ye) could modulate the inflammatory effects in activated human neutrophils through multiple independent signaling pathways (PMID: 26659126). Bacterial infections can be prevented and treated with an array of strategies in CIM/TCM, and regular short courses of treatment could be invaluable, and decrease the need to over-prescribe antibiotic drugs. To see more information on the immune system and scientific studies confirming the benefits of acupuncture and herbal medicine to enhance this system, go the article on this website entitled Immune Dysfunction and Restoring Immune Homeostasis.
A variety of herbal medicines and foods have been well studies and found to support antibiotic immune functions in the body and actually help modulate the Biome and immune responses to maintain a protective balance. In 2010, experts at the Cyril and Methodius University School of Medicine and Pharmacy, in Skopjae, Macedonia, published a comprehensive study of the historical use of species of garlic (Allium) and garlic preparations to support biotic balance. While the worldwide use of Allium species became so obviously effective, leading to many myths regarding garlic that persist today, scientific study reveals that indeed the chemicals in garlic and varius Allium species are antibiotic as well as probiotic. To see this study, just click here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249897/ . In Traditional Chinese Medicine, garlic and various Allium species are promoted as fresh garlic, aged garlic extracts, and even topical garlic preparations, and a variety of medicinal effects are touted, although the idea that a little common food garlic cut fresh in the diet provides all of these effects is obviously an oversimplification. A 2011 study at the University of Sienna School of Medicine, in Italy, proved that traditional aged garlic extracts, and wild type garlic species, provide the amazing antioxidant potential and medicinal benefits not achieved with simple common commercial garlic bulbs. To see this study, just click here: http://www.ncbi.nlm.nih.gov/pubmed/21290188 . In recent years, the study of chemicals in this aged garlic preparation from wild types of garlic have proven that this herbal medicine also provides significant effects to reduce arterial plaques and anticancer effects. Inflammatory dysfunction related to low grade bacterial toxicity are implicated in these diseases, and simply taking anti-cholesterol medication and antibiotics has proven to be failing to prevent these diseases. A more holistic protocol is needed. Chinese herbal formulas with aged garlic, Astragalus and various symbiotic herbs provides signficant effects to counter such bacterial endotoxin and low-grade Pleomorphic bacterial infections.
A 2016 study at at the National Centre for Disease Control in India showed that common and simple herbs used in many Traditional Chinese herbal formulas, such as licorice root (Gan cao, or Glycyrrhiza or Glabra), ginger (Zingiberis, or Sheng jiang or Gan jiang), and field mint (Bo he), showed signficant potential against multi-drug resistant Pseudomona aeruginosa, which now threatens many patients each year in the United States with gastrointestinal enteritis (PMID: 27083519). A 2007 study at the Kaohsiung Medical University in Taiwan showed that one of the most famous herbal medicines to treat endemic infectious disease, wild Cinnamon bark (Gui zhi) was effective to greatly enhance the effects of common antibiotics to treat antibiotic resistant strains of Pseudomonas in the hospital setting (nsocomial infections). The most classic text of TCM herbal medicine bases a variety of formulas on these herbs, wild cinnamon bark, ginger, field mint and garlic, adding an array of antimicrobial and support herbs to formulas to effectively treat endemic disease, with Gui zhi Tang the base for these formulas in the Shang Han Lun texts. Unfortunately, the use of the classic formulas from the Shang Han lun now are not widely prescribed, with a 2009 study in Taiwan showing that they currently represent only about 5 percent of all the many Chinese herbal formulas prescribed today (PMID: 19781366). Today, these classic animicrobial disease fomulas are proving to be effective, but there are many more formulas even more effective, and as research and interest in herbal medicine increases, there will be more and more randomized controlled human clinical trials as well as in vivo and in vitro studies of specific herbal chemicals and effects to guide the elaborate therapeutic options. Public awareness and acceptance by the standard medical community are all that prevents its benefits today.
Evidence that herbal medicine and acupuncture are effective to treat bacterial infection or support present therapies in a Complementary manner
A growing body of scientific evidence is convincing experts that herbal medicine may be the answer to overuse of antibiotics and the problem of drug resistant strains of bacteria (refer to informational resources below). The study of herbal chemicals has produced surprising results concerning the specificity of action of these chemicals and the safety. Plants have evolved a very complex response to bacterial infection over the millions of years, often with a modulatory response that is still not clearly explained by modern science. Scientists are finding that the full spectrum of chemicals in specific plants are also more effective than an isolated active chemical, and this points to the supposition that the plant had evolved more complex chemistry to protect it against unwanted effects, and insure that the antimicrobial antibacterial effects were triggered in a more effective and self-modulatory manner. This type of research is proving to be a potential boom for biochemical research in the future, as new ideas are generated in achieving improved effects and safety of pharmaceuticals.
Herbal medicine may be used to prevent bacterial infection as well as to treat it, either by itself, or combined with antibiotics and other antimicrobial drugs. Herbal medicine and acupuncture may also be used to alleviate the side effects of these synthetic drugs or standard antibiotics. In addition, herbal prescription and acupuncture may be used to strengthen the immune system to help the natural defenses in an age of threatening drug-resistant strains of common bacteria.
Herbal extracts were widely used before the first antibiotics were discovered in the twentieth century to treat bacterial infections. For instance, the herbal chemical benzoinum (Styrax benzoin / An xi xiang), and other antibacterial and antipyretic chemicals in this tree extract, were described in King's American Dispensatory in 1898, and in the United States Pharmacopeia (USP) in 1881, as effective against E. coli and other bacterial infections. Recent study of benzoinum in China reveals that a concentrated dosage of An xi xiang will inhibit the growth of E. coli, whereas a low concentration dosage will encourage E. coli growth. Depending upon herbal products sold in the grocery or other non-professional sources of herbal products may thus have a negative rather than positive effect. Depending on an evidence-based professional herbalist assures patients that the desired effect will be achieved. Today, the public may access these pharmaceutical texts from the past to see the many references to herbal extracts that had potent antibacterial, anti-inflammatory, and antipyretic effects. This is just one of many examples of herbal medicines known and used clinically to treat bacterial infections. To see current research confirming these herbal antibacterial and antibiotic effects, to the section of this article entitled Additional Information.
A 2014 randomized controlled multicenter study of the efficacy of herbal medicine to treat small intestine bacterial overgrowth, by the esteemed Johns Hopkins University Medical School Hospital and the University of Pittsburgh Medical Center, along with the University of Texas Southwestern School of Medicine, and the Trinity Health Center in Minot, South Dakota, confirmed that: "Herbal therapies are at least as effective as refaximin (Rifagut or Xifaxan) for resolution of SIBO (small intestine bacterial overgrowth) (determined) by LBT (lactose breath testing). Herbals also appear to be as effective as triple antibiotic therapy for SIBO rescue therapy for refaxim non-responders (antibiotic-resistant strains)." (PMID: 24891990) You may see a link to the study summary below in Additional Information. The specific herbs were not mentioned in the summary, but professional prescription with assured professional herbal products is very important with this integrative and complementary treatment approach, as well as restoration with a professional probiotic formula.
Many of the herbs studied show a dose-dependent effect, and the quality of the herbal product should always be questioned, especially in the United States, where the FDA still has not instituted regulations that protect the public against false labeling and product quality of herbal medicine and supplements. A professional herbalist insures that the dosage and quality is going to be effective, and will monitor your case, adjusting the prescription as needed. The professional herbalist will also be able to prescribe the variety of herbs to achieve the full range of results described above, and to administer the herbs in the form of formulas that have a tested history and are based on sound theories of herbal formulation.
Of course, herbal medicine and acupuncture are not an "alternative" to standard care and antibiotics, and should not be taken lightly in treatment as such. With real medical problems, utilization of a professional herbalist that is highly trained in specialized medical schools and understands herbal efficacy, dosage and toxicity is important. Misuse of herbal medicines and self-medication is quite common but comes with risks, especially in vulnerable populations, such as children. For instance, a 2015 study at the China Military Institute of Chinese Medicine and the 302 Military Hospital and Medical School of Chinese PLA, in Beijing, China, where Integrative Medicine is provided, a retrospective study of 69 consecutive cases of drug-induced liver injury in children between 2009 and 2011 was conducted, and both pharmaceuticals and herbal medicines were implicated. The major cause of this drug-induced liver injury in the treatment of children was antibiotic prescription, but herbal therapy with Ephedra (Ma huang) and Polygonum cuspidatum (He shou wu) also produced harm, and was probably self-administered by parents. The acute level of liver injury with these more potent types of herbal medicines was greater than with pharmaceuticals, but the long-term outcomes showed that this injury with herbal medicines produced much less chronic liver injury than pharmaceuticals. About 35 percent of these randomly chosen consecutive cases showed chronic liver injury, mainly from pharmaceutical treatment (PMID: 25717050).
The lesson to be learned is that herbal medicines should be prescribed by highly trained professional herbal specialists in real medical care. Even Medical Doctors can administer improper herbal medicines and dosages, often receiving little real training in herbal medicine in standard medical schools, but TCM physicians are taught that excessive dosage and stronger herbs should not be prescribed to infants and children. In addition, when herbal medicines are widely available without professional prescription, as in China, parents and individual adults relying on advertising and non-professional information and guidance can cause harm. Thoughtful integration of standard care and specialized professional herbalists, such as Licensed Acupuncturists and herbalists, and Naturopathic Doctors, would solve this problem. Only with the urging of change by the public, and by patient choices, can this be accomplished. In the meantime, the questions concerning overuse of antibiotics, with a greater understanding of actual risks versus benefits, and choices in treatment, need to be handled with much greater public understanding to make the right choices, and a more proactive approach. The patient and the parents of patients need to be the main decision makers.
If you have any other questions concerning antibiotic use and herbal alternatives, feel free to discuss them with me.
Information Resources / Additional Information and Links to Scientific Studies
Below are some of the examples of current research concerning antibiotics, and proving the safety and efficacy of Chinese herbal medicines in the treatment of bacterial infections, including drug-resistant strains that are threatening our population. The actual database of such studies is enormous, with most of the study still unpublished by Western medical journals, but available to the TCM practitioner in clinical textbooks and herbal reference texts from China, Japan and Korea.
- A history of antibiotics, with penicillin discovered in 1928 but not synthesized for patented manufacture until 1959, and streptomycin discovered in 1943 and also developed for wide use by 1960, as well as other antibiotics derived from actinomycetes in the soil, is presented by experts at ac.uk - showing the details of how all early antibiotics were discovered by research of natural biological mechanisms in microorganisms and plants. We see here the concern that the widespread use of antibiotic genes as biomarkers to identify GMO crops, and left in the genetically modified organisms for no good reason may also be contributing to the rapid spread of antibiotic resistance genetic traits. We also see why there are not really any new types of antibiotics discovered for decades, only a lot of variants of the approximately 10 types discovered that are toxic to microbes but not to human cells: http://archive.bio.ed.ac.uk/jdeacon/microbes/penicill.htm
- A 2016 report from the U.S. Centers for Disease Control and Prevention (CDC) states that each year in the United States at least 2 million people now acquire a bacterial infection that is resistant to antibiotics, and at least 23,000 die directly from these infections. An urgent need exists to develop more comprehensive plans to both prevent and treat these infections, yet integration of Complementary Medicine, the obvious realm of treatment before the introduction of antibiotics, and the source of most antibiotics, is still rarely mentioned: http://www.cdc.gov/drugresistance/http://www.cdc.gov/drugresistance/
- A 2012 report from the both the U.S Centers for Disease Control and Prevention (CDC), and the European Centre for Disease Prevention and Control (ECDC) shows that by this time resistant strains of almost all virulent bacteria and other microbes were ubquitous around the world, requiring a common labeling as multidrug resistant (MDR), extensively drug resistant (XDR) and pan-drug resistant (PDR = all known types of drug available). Obviously, there is the urgent need to develop new strategies to help with this very threatening health problem, and obviously a more holistic approach is needed now, not a decade from now: http://www.sciencedirect.com/science/article/pii/S1198743X14616323
- A 2015 article in Discover Magazine reveals that more and more bacteria are resistant to all known antibiotics or resistant to many types of antibiotics, with the term "superbugs" commonly used. This threat is very serious and negates standard therapy. With the problems eliminating bacterial infections in the large hospitals, everyone is becoming very alarmed: http://blogs.discovermagazine.com/d-brief/2015/12/11/antibiotics-are-powerless-against-this-new-superbug/
- A report from the U.S. NIH National Institute of Allergy and Infectious Diseases, in Bethesda, Maryland, U.S.A. shows that eosinophilia-related diseases were a rising concern in 2007 and that in areas where helminth and other fungal and parasitic diseases were rare, that overuse of antibiotics and NSAIDS were the predominant cause of infiltrating eosinophilia and related asthma, esophagitis and gastritis in children. The health of the host immune barriers, gut membranes, and adrenal steroid health were also important in these diseases, allowing infiltration of both eosinophils when they were stimulated, and the parasitic allergens and toxins that attract this eosinophil infiltration to problematic tissues: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2099264/.
- A 2008 paper from experts at the University of Bristol, in the UK, explains that bacteria are one of the first intelligent species on the planet, and have evolved ways to protect themselves for billions of years. The use of genetic plasmids and viruses to pass this adaptive knowledge horizontally through the species, rather than via reproduction, explains much of the threat of rapid development of resistance to antibiotic chemicals: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2268074/
- A 2015 research study at the University of Copenhagen Center for Diabetes Research found in a broad population-based study that the amount of use of antibiotics is clearly related to risk of Diabetes Type 2, sometimes with onset over a decade later than the repeated long courses of antibiotics, showing that the Human Biome is very important to human metabolism, and destruction of the Biome by unnecessary use of antibiotic therapy creates a burden of disease: http://press.endocrine.org/doi/abs/10.1210/jc.2015-2696
- A 2001 report by experts at the Uniformed Services University of the Health Sciences, in Bethesda, Maryland, U.S.A. published in the Oxford Journals of Clinical Infectious Diseases, noted that at this time Clostridium difficile, or C. difficile infection of the intestinal tract in hospital care was rare, with just 9 cases reported the prior year in the United States, but was caused by antibiotic overuse, and presented a serious threat to patients, especially patients with inflammatory bowel disease and the elderly. By 2011, the U.S. Centers for Disease Control reported a conservative estimate of over 1400 deaths from C. difficile enteritis in the hospital setting, showing that the warnings of antibiotic overuse were not heeded, and the problem was spiraling out of control: http://cid.oxfordjournals.org/content/33/8/1429.full
- A 2012 U.S. FDA drug warning for increased risk of Clostridium difficile enteritis for patients taking acid inhibiting drugs that are commonly used: http://www.fda.gov/Drugs/DrugSafety/ucm290510.htm
- A 2016 added warning by the U.S. FDA to the class of antibiotics called fluoroquinolones (Cipro, Levaquin, Noroxin, Floxin, Factive etc.), previously with warnings concerning the increased risk of Clostridium difficile enteritis, increased the extent of guideline restriction of this class of antibiotics due to evidence of even more alarming health risks, affecting the central and peripheral nervous system and health of joints and tendons: http://www.fda.gov/Drugs/DrugSafety/ucm500143.htm
- A thorough explanation of common antibacterial agents in commercial use and the known harm, risk and lack of real benefits from such industrial chemicals now ubiquitous in soaps, cosmetics and household cleansers, is presented by the Alliance for the Prudent Use of Antibiotics (APUA), sponsored by Tufts University. APUA is located in Boston, Massachusetts, U.S.A., on the campus of Tufts University Medical School, and consists of recognized medical and scientific experts, including Nobel laureates and members of national academies of medicine and science, showing that such concern is not just coming from a radical fringe of society, but is a real concern of conservative scientific experts: http://www.tufts.edu/med/apua/about_issue/agents.shtml.
- A thorough explanation of the history of antibiotics and antibiotic-resistance is available here, on this site developed by Wiley for college medical instruction. We see from these experts that the Chinese utilized the first specific antibiotic, derived from a mold, more than 2500 years ago, and it was not until 1929 that scientists in the West duplicated this. Various classes of antibiotics are explained here, providing help in devising more specific protocols for specific infections: http://www.wiley.com/college/pratt/0471393878/instructor/activities/bacterial_drug_resistance/index.html
- Research in 2014, in China, found that among active chemicals in Chinese herbs that exhibited the strongest antibacterial effects, the bitter tasting chemicals were indeed most effective, as TCM theory has stated for thousands of years. Alkaloids from Coptis chinensis, or Huang lian, perhaps the most widely used antibacterial herb, were studied, such as Berberine: http://www.ncbi.nlm.nih.gov/pubmed/25522621
- An example of the type of antibacterial herbal research being conducted in 2008 is presented on the National Institute of Health's research database PubMed. Here we see that a specific Chinese herb, Yu xing cao, or Houttuynia cordata, has been tested in the laboratory in vitro, as well as in living subjects in vivo, and has shown to be safe in normal cells, and immediately effective in cells infected with salmonella (gram negative Proteobacteria), inducing effective nitric oxide response and reducing the rate of mortality: http://www.ncbi.nlm.nih.gov/pubmed/18981565
- The antibacterial mechanisms of antibacterial Chinese herbs were researched in 2015, by experts at Wonkwang University, and Euji University, in South Korea, and an active chemical in Lithospermum erythrorhizon, or Zi cao, called Shikonin, was found to affect the permeability of the bacterial membrane, the peptidoglycan outer layer of the bacteria, and the ATP-binding in Methicillin-resistant Staphylococcus aureus (MRSA). Such research confirms that need to integrate Chinese herbal medicine into standard care of bacerial infections, especially antibiotic-resistant strains: http://www.ncbi.nlm.nih.gov/pubmed/26265924
- An example of the research combining herbal extracts with standard antibiotics to increase efficacy against drug-resistant strains of bacteria is shown here in a published study in the Journal of Microbiology and posted on the PubMed database. The herbal chemical studied, galangin, is found in a Chinese herb Gao liang jiang, or galanga, which is also used in food preparation: http://www.ncbi.nlm.nih.gov/pubmed/18604497
- Research into herbal antibiotics and use in Complementary Medicine to work synergistically with standard antibiotics has been conducted in Europe for some time. This study from the School of Pharmacy or Robert Gordon University in England was conducted in 2000, and shows that a standard antibacterial Chinese herb, Huang qin, or Scutellaria baicalensis, with the chemical baicalin, acts synergistically to increase the effectiveness of standard antibiotics against methicillin-resistant Staphylococcus aureus and other resistant strains of Staph: http://www.ncbi.nlm.nih.gov/pubmed/10757427
- A 2016 study of the Chinese herbal chemical Baicalein, from Scutellaria baicalensis, or Huang qin, by experts at the Guangxi Medical University in Nanning, China, shows the biochemical pathways by which this herbal chemical both inhibits such infectious antibiotic-resistant bacteria as Pseudomonas aeruginosa, and also stimulates a modulating effect on inflammatory cytokines: http://www.ncbi.nlm.nih.gov/pubmed/26792984http://www.ncbi.nlm.nih.gov/pubmed/26792984
- Research into herbal antibacterial chemicals and their efficacy combined with standard antibiotics at the University of Birmingham, UK, in 2011, showed that herbal medicinals contain inhibitors of bacterial efflux in gram-negative bacteria that make them valuable as synergistic medicinals used with standard antibiotics, and that this effect apparently was achieved with a combination of herbal chemicals, not a single standardized extract. Such studies show how the whole herb extracts used in Chinese herbal medicine are needed to create an effective synergistic effect and integrate with standard antibiotic use: http://www.ncbi.nlm.nih.gov/pubmed/21194895
- A 2014 randomized controlled multicenter study of the efficacy of herbal medicine to treat small intestine bacterial overgrowth, by the esteemed Johns Hopkins University Medical School Hospital and the University of Pittsburgh Medical Center, along with the University of Texas Southwestern School of Medicine, and the Trinity Health Center in Minot, South Dakota, confirmed that professional herbal formulas are as effective as the commonly prescribed antibiotic rifaxim for diagnosed small intestine bacterial overgrowth: http://www.ncbi.nlm.nih.gov/pubmed/24891990
- A 2013 study of 58 traditional Chinese herbs used to treat microbial infections and inflammation, by the University of Western Sydney, in Australia, showed that 30 of these 58 studies exhibited significant antimicrobial effects against fungal and bacterial overgrowth. The degree of effect was correlated with the amount of flavonoids in the herbal extracts, and alcohol extracts were used. 23 of the 58 herbs showed significant antibacterial effects, and 8 showed both anti-fungal and anti-bacterial effects, including Polygonum cuspidatum (Hu zhang, the source of Resveratrol), Uncaria rhyncophylla (Gout teng), Eucommia ulmoids (Du zhong), and Poria cocos (Fu ling): http://www.ncbi.nlm.nih.gov/pubmed/23827142
- A 2014 study at Dayananda Sagar College, in Bangalore, India, found that 11 of 25 selected herbal extracts were effective in treating a multi-drug resistant strain of Streptococcus, with a number of beneficial effects noted, including inhibition of bacterial endotoxins: http://www.ncbi.nlm.nih.gov/pubmed/24694051
- Research into herbal antibacterial effects of Urtica doica, or Stinging nettle, in alcohol extracts (various solvents), in 2012 at the University of Sains Malaysia, found that extracts were effective against MRSA (methycillin-resistant staphyloccocus) and were effective for both gram positive and negative bacteria: http://www.ncbi.nlm.nih.gov/pubmed/23342511
- A 2012 study at the University of Fort Hare, in Alice, South Africa, found that an alcohol extract of Acacia mearnsii de Wild produced a strong synergistic effect with antibiotic drugs to improve efficacy against multi-drug resistant strains of many pathogenic bacteria: http://www.ncbi.nlm.nih.gov/pubmed/22942742
- A 2014 multicenter meta-review of herbal medicines as antibacterials, conducted by the University of Pavia, in Italy, and Baqiyatallah University, in Iran, noted that many herbs, even strains of spice herbs such as thyme, contain high content of antimicrobial active chemicals, such as polyphenols, flavonoids, tannins, and alkaloids: http://www.ncbi.nlm.nih.gov/pubmed/25466031
- A 2016 study wild ginger, common ginger, and prepared ginger extracts in medicine for their antimicrobial and antibiofilm effects, by experts at the Tabriz University of Medical Sciences, in Iran, shows that their are signficant antifungal and antiobiofilm effects, and these extend to antimicrobial effects as well, countering pathological growth of E. coli, Staph, Klebsiella, Pseudomonas and other common infectious bacterial diseases. Clearly, we see from such study that positive benefits from combinations of these herbs in formulas: http://www.ncbi.nlm.nih.gov/pubmed/27127591
- A 2015 study at the Dayananda Sagar Institute, in Bangalore, India, utilized both herbal chemical databanks, and the latest 3D computerized chemical analysis, to show that specific herbal chemicals had pharmacokinetic properties that exerted significant antibacterial effects. This particular search was for herbal chemicals that could be integrated to counter infection by Listeria monocytogenes, a gram-positive bacteria in gastrointestinal infections that has become widely antibiotic resistant. Preliminary testing of viable herbal chemicals to inhibit the secretory proteins in Listeria showed that cinnamic aldehyde from Cinnamomum camphora and 1,2-Epoxycyclododecane for Cassia auriculata were potent SecA inhibitors. Such research will not only finally prove the potential of herbal medicine as adjunct treatment for bacterial infections and antibiotic-resistant infections, but will help the herbalist better guide therapy in an integrated medical arena: http://www.ncbi.nlm.nih.gov/pubmed/25562366
- Gram positive bacteria such as Clostridium, Staphylococcus, and Streptococcus species, are effectively treated with many herbal antimicrobial extracts. This 2011 study showed that herbal medicines such as Curcumin (E zhu) exhibited a potential for docking of the herbal antibacterial chemical with the toxin in gram positive bacteria comparable to standard antibiotics: http://www.ncbi.nlm.nih.gov/pubmed/21904424
- A 2016 study at the Denver Veterans Affairs Center, the University of Nebraska and University of Colorado Schools of Medicine, in the U.S.A. and the Shaanxi University of Chinese Medicine, in China, found that Curcumin, a chemical in a number of Chinese herbs (E zhu and Yu jin) protects against tuberculosis infection, and would be effective for antibiotic-resistant strains of TB: http://www.ncbi.nlm.nih.gov/pubmed/27012592
- A 2012 study at the National Institute of Pharmaceutical Education and Research, in Punjab, India, noted that laboratory studies showed that the simple Chinese and Indian herb, Alpinia Galanga, or Gao Liang Jiang, contained phenylpropanoid chemicals that act as significant efflux pumb inhibitors in cells infected with mycobacterium Tuberculosis, enhancing the effects of standard drug therapy for drug-resistant, or any type, of TB: http://www.ncbi.nlm.nih.gov/pubmed/22735598
- A 2004 study at the Fudan University School of Medicine, in Shanghai, China, found that integrating Chinese herbal formula with standard treatment of Irritable Bowel Syndrome with Clostridium butyricum probiotic significantly enhanced the ultimate balance of microbiota in these patients: http://www.ncbi.nlm.nih.gov/pubmed/15383254
- A 2015 study at the Wonkwan University School of Medicine, in South Korea, demonstrated that the combination of the Chinese herbal chemical Morin, found in various mulberry species medicinals, such as Sang zhi, or Morus alba, with Beta-lactam antibiotics, such as Penicillin, Amoxicillin, Oxacillin, Ampcillin, and Carbapeneum, showed effectiveness against Methicillin-resistant Staphylococcus aureas, or MRSA, that was much more effective than the antibiotic alone: http://www.ncbi.nlm.nih.gov/pubmed/26067230
- A 2015 broad study of the effects of an integrative combination of herbal antimicrobials with antibiotics, by experts at the Kohat University of Science and Technology, in Kohat, Pakistan, found that flavonoid-rich herbal extracts were found to increase the effectiveness of antibiotics in almost all cases studied, with no adverse effects, and in some cases a synergistic effect was observed, increasing the effectiveness of the antibiotic drug, which may allow decrease in dosage or length of treatment, reducing risk of antibiotic resistance: http://www.ncbi.nlm.nih.gov/pubmed/25879586
- A June 3, 2011 article in the New York Times explains how antibiotics should not be utilized in an outbreak of antibiotic-resistant E. coli that is food borne, yet the treating doctors used one course of antibiotic after another to treat their patients, creating a more dangerous infection as the normal bacteria in the gut are destroyed. The article also clearly outlines how overuse of antibiotics as growth promoters in the meat industry created a large exposure, via wastewater, to this emerging strain of E. coli on vegetable crops, which resulted in an evolved antibiotic resistance. The WHO and UN health agency stated that antibiotics should not be used for such bacterial infections, and that studies now show that antibiotics for E. coli at best have no effect and at worst the drugs may worsen the infection: http://www.cbc.ca/news/world/story/2011/06/03/contaminated-veggies-europe.html // http://www.nytimes.com/2011/06/03/health/03treatment.html NOTE: New York Times web articles may now be censored by the company that owns this publication. You may need to search for the article entitled U.S. Calls Antibiotics Wrong Step on E. Coli, or U.S. Calls Antibiotics Wrong Step In Outbreak.
- Research in 2011 at the Chonbuk National University in Jeonju, Korea, found that a classic combination of Chinese herbs effectively exerted an antibacterial effect on virulent E. coli strains. Hemorrhaghic E. coli strains resistant to multiple antibiotics were effectively inhibited from releasing shiga toxin with the herbal combination of Mume fructus (Wu mei), Shizandrae fructus (Wu wei zi) and Coptidis rhizome (Huang lian), a classic combination of herbs long used to treat bacterial dysentery in China: http://www.ncbi.nlm.nih.gov/pubmed/21214372
- A 2014 clinical study at the First Affiliated Hospital to Changchun University of Chinese Medicine, in Changchun City, China, found that a common TCM herbal formula to treat kidney infection successfully cleared a serious infection with multi-drug resistant Pseudomonas aeruginosa with an 8-day course of herbal treatment, and 2 weeks later, the urine showed no Pseudomonas 2 weeks after completing therapy: http://www.ncbi.nlm.nih.gov/pubmed/23869971
- Research in 2011 at Kyung Hee University in Seoul, South Korea, demonstrated how a key chemical in the Chinese herb Hou pou, or Magnolia officianalis, honokiol, significantly protects bone cells, or osteoblasts, against degenerative damage induced by Antimycin A, which inhibits cellular electron transport and induces oxidative stress. Honokiol significantly increased the cell viability and ability to deposit calcium in bone. Antimycin A is a metabolite produced by Streptomyces bacteria and is an active ingredient in a number of chemical agents such as piscidide, a widely used antibiotic in fish farming, which has been shown to inhibit CoQ10 (ubiquinol) and the production of ATP in cells, and inhibit the electron transport along the ferredoxin quinone pathway. Antimycin antibiotics are not used in human medicine, but are increasingly used in commercial meat and fish production to inhibit active fungi: http://www.ncbi.nlm.nih.gov/pubmed/21800176
- Research in 2011 at Kyung Hee University in Seoul, South Korea, demonstrated how a key chemical licorice root, or the Chinese herb Gan cao, prevents osteoblastic damage induced by Antimycin A as well. This chemical, Glabridin, is now standardized for use in nutritional medicine, but is proven in double-blind placebo studies to reduce body weight in obesity, increase burning of body fat, and help maintain blood glucose levels. For the obese or overweight patient with osteopenia, this supplement could be very useful. Glabridin may act as a phytoestrogen as well as a metabolic stimulator, and should be used with supervision. Such standardized extracts from the Chinese herb Glycyrrhiza glabra, have been developed because a high dosage of licorice root itself is problematic in many patients (hence the use of deglycerized licorice root extract): http://www.ncbi.nlm.nih.gov/pubmed/21621525
- Research in 2011 at Kyung Hee University in Seoul, South Korea, demonstrated how a key chemical in many herbs and foods, kaempferol, a flavonoid, also shows significant benefits in protecting bone cells from cytotoxicity that may be induced by antibiotics. This flavonoid is widely studied as a beneficial aid to prevent a variety of degenerative conditions, including neurodegeneration. Kaempferol is found in many herbs, including horsetail, matricaria, geranium, syzygium, ammni visnaga, albizzia, barberry, astragalus, echinacea, boneset, St. John's Wort, vitex, wolfberry or gou qi zi, magnolia or hou pou, sang bai pi, lian zi xin, chi shao, cat's claw uncaria or gou teng, and ginseng, and a number of common fresh foods: http://www.ncbi.nlm.nih.gov/pubmed/21565246