Antibiotic Use and Health Considerations

Paul Reller, L.Ac.

It has been universally recognized that antibiotic use in the United States has been overutilized, 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 antibiotic-resistant strains of common bacteria. 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. In a recent study, 50% of cases of bacterial pneumonia were shown to be antibiotic resistant, presenting an increasingly dangerous threat to the population. 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 disorder later in life due to the deep bacterial infection (see the article entitled Bacterial Endotoxins on this website).

The U.S. Center for Disease Control, or CDC, has deemed antibiotic resistance a serious threat to public health, and standard medicine has been slow to change its prescribing guidelines. 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. Even individuals that have not personally overused antibiotics are profoundly affected by antibiotic resistant strains of bacteria, and by the altering of the bacterial balance in our bodies that has resulted from the enormous amount of antibiotics accumulating in our environment. Complementary medicine offers some healthy alternatives and complements with herbal antibacterial, antiviral and antifungal chemical extracts that can be integrated into your health care when appropriate. Complementary Medicine also offers the patient effective means to prevent infection and improve the health of the immune system. To make this choice, the patient needs to know the facts:

Not only the widespread prescription of antibiotics, but also excessive prescription of other drugs to treat virulent diseases is causing a huge health crisis around the world. Eventually, this worldwide health problem will creep into the lives of many of us in the U.S. who are 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. The overprescription 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 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% of all antibiotics used, or overused, in the United States were used in agriculture, and that 70% of these drugs were used simply to promote animal growth, not to treat infection. Even industry trade associations admit that an estimated 13% of antibiotics used in the raising of beef, pork and chicken were used solely to promote growth. 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: http://www.nytimes.com/2010/06/29/health/policy/29fda.html?scp=1&sq=antibiotics&st=cse. To better understand this complex problem and the implications of antibiotic use when unnecessary, read some of the facts:

Another serious cause of antibiotic resistance is the overuse of antibacterial chemicals in the United States. 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 in 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. In all of these instances, reviews of scientific data in response to industry objections were never completed. In 2005, an FDA advisory panel 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 the 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!

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 now. For instance, there is a significant prevalence of antibiotic resistance to the two most common bacterial middle ear infection agents.

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 doxyclycline. Even in 1999, Cipro was the eleventh most prescribed drug in the United States based on new prescriptions. Clearly, most of this prescription of Cipro was made purely for profit, not for public health concern.

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.

The need to fasttrack 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 fasttrack 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.

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. 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. 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. 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 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, fatique, arrhythmias, short term memory loss, neuralgia, chronic fatique 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).
• Sulfa drugs are called ‘antibiotic’ but are actually synthetic drugs, like fluoroquinones, that compete with bacteria for enzymes needed for the bacteria to reproduce. 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. 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 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.
• 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.
• 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 underreporting. 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)
• 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.

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.

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 antiobiotics are used. 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

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. 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, 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, 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.

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.

Many of the herbs studied show a dose-dependant 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 efffective, 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.

If you have any other questions concerning antibiotic use and herbal alternatives, feel free to discuss them with me.

Information Resources

Below are some of the examples of current research 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.

1. 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, inducing effective nitric oxide response and reducing the rate of mortality: http://www.ncbi.nlm.nih.gov/pubmed/18981565
2. 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
3. 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
4. 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
5. 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.
6. 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

The information on this website is not intended to be used as a specific medical advice or cure. Please consult with the practitioner or an appropriate physician, such as a licensed acupuncturist, naturopath, or medical doctor, to discuss the proper application of the information contained on this website.