Combining Herbal Approaches for Improved Antibiotic Stewardship
The very first antibiotic created was penicillin and it was quickly produced and distributed in the 1940’s. This began a miraculous journey through medicine where we discovered more novel antibiotics and were able to treat infections that once may have been fatal.
An amazing feat to be sure! Unfortunately, antibiotics and their remarkable ability to treat infectious diseases, have been compromised by their misuse and overuse over the years, leading to the widespread emergence of antimicrobial resistance.
Antibiotic stewardship is a coordinated effort to improve how antibiotics are prescribed and used by clinicians and patients, ensuring they get the right drug, dose, and duration for the right infection, to optimize patient health and combat rising antibiotic resistance. It’s about using these precious medicines wisely to get the best outcomes while minimizing side effects, C. difficile infections, and resistance. Patient safety and future treatment should be at the forefront of our practices when prescribing due to the increasing prevalence of antibiotic resistance.
Phytocompounds found in herbs frequently exhibit potent antibiotic action, but not quite as strong compared to conventional antibiotics. The amalgamation of both natural compounds with existing antibiotics is an effective way to address the issue of antibiotic resistance. Synergism refers to the situation when the combined therapeutic impact of two substances exceeds the sum of their impacts. This has been clearly divulged in the literature when combining antibiotic medications with antimicrobial herbs. Herbs have many mechanisms of action that are too complex for bacteria to sort through and build resistance to, compared to antibiotic medication which is one mechanism that bacteria quickly figure it.
Think of combining antibiotics and herbs like a trojan horse – we hide the powerful antibiotic in the complexities of a herb so the bacteria never see what hit them!
Examples of herbal synergy with antibiotics includes the use of berberine (a compound found in Oregon grape and goldenseal) with vancomycin when treating C.difficile associated diarrhea for increased efficacy of treatment.
Quercetin (found in apples, citrus, onion) and apigenin (found in parsley, celery, chamomile) are flavonoids known for their antibacterial effects against H. pylori and E. coli by inhibiting D-alanine which is needed to create the bacterial cell wall. H.pylori is a particularly stubborn organism to treat and the standards currently require quad therapy (2 antibiotics, bismuth and PPI) or concomitant therapy (3 antibiotics and a PPI).
Naturopathic medicine has a crucial role in upholding antibiotic stewardship while making sure the patients treatment is effective for them long term. We will always try to incorporate the health of the patient, the community and the environment.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC7303057/
- https://www.sciencedirect.com/science/article/abs/pii/S0924857925000263
- https://pubmed.ncbi.nlm.nih.gov/38056887/
- https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2021.709749/full
Dr. Jennifer Kerr, ND
