Since the introduction of antibiotics into clinical practice in the 1940s, antibiotic resistance has been a rapidly increasing global health concern, primarily due to the inappropriate use of these agents (1). The growing number of resistant infections makes effective treatment more challenging and is associated with poorer health outcomes and complications (2). According to the CDC, more than 2.8 million antimicrobial-resistant infections occur annually, resulting in over 35,000 deaths (6). Addressing the problem requires a multi-faceted approach that emphasizes the prevention of infection spreading, the appropriate use of antibiotics, and the exploration of alternative antimicrobial agents when possible.
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How do Antibiotics Work?
Antibiotics are a type of medicine that help manage bacterial infections by affecting bacteria. There are many types of antibiotics, and they all have different mechanisms of action. Depending on the type and severity of the infection, an antibiotic may be administered orally, topically, or intravenously. (3)
An antibiotic can be classified as a broad-spectrum or narrow-spectrum antibiotic. Broad-spectrum antibiotics are effective against a wide range of bacteria, whereas narrow-spectrum antibiotics will only affect a few types of bacteria. The use of narrow-spectrum antibiotics is restricted to scenarios where the bacterial pathogen has been identified. (4)
A bactericidal antibiotic affects the bacteria by interfering with the formation of the bacterial cell wall or its cell contents. A bacteriostatic antibiotic helps manage bacteria by stopping them from multiplying to support the natural immune system in managing the infection. (4, 5)
What is Antibiotic Resistance?
Antibiotic resistance occurs when bacteria develop the ability to withstand the effects of drugs designed to manage them (6). Bacteria may become resistant to antibiotics through various means. A bacteria may use one of the following mechanisms to evade an antibiotic's effects (7):
- Restriction of access by changing the cell's entryways
- Production of pumps in the cell wall to push antibiotics out of the cell
- Change or destruction of antibiotics with enzymes
- Induction of change to an antibiotic's target so it no longer has its desired effect
- Development of new cellular processes for survival without using the antibiotic's target
Antibiotic resistance was noted soon after penicillin was widely used to manage infections among World War II soldiers in the 1940s and became a widespread problem in the 1950s. New antibiotics are developed to combat the problem; however, resistance is now seen to nearly all antibiotic classes. (8)
Signs & Symptoms of Antibiotic Resistance
Bacterial infections can cause symptoms in almost every body system, depending on the location of the infection. If you are sick with an antibiotic-resistant infection, symptoms may not improve with antibiotic therapy. (9)
Some of the most common general signs and symptoms of infection include:
- Fever
- Chills and sweats
- Swollen and painful lymph nodes
- Fatigue
- Headache
- Body aches and pain
- Gastrointestinal symptoms: nausea, vomiting, diarrhea, abdominal pain
- Respiratory symptoms: cough, runny nose, nasal congestion
- Ear and Throat symptoms: ear pain, sore throat
How Serious Is Antibiotic Resistance?
According to the World Health Organization, antibiotic resistance is one of the biggest threats to global health, food security, and development (2). At least 700,000 people die each year due to drug-resistant diseases. Without action, death tolls could increase to 10 million deaths annually by 2050. (10)
Antibiotic resistance can affect anyone of any age and in any country. Antibiotic resistance makes the management of infections more complicated and, perhaps, impossible. It leads to extended hospital stays, higher medical costs, increased risk of side effects from second and third-line treatment options, and increased mortality. (2, 6)
Possible Causes of Antibiotic Resistance
Antibiotic resistance can occur naturally through bacterial mutation and evolution, but other controllable factors accelerate the process (2).
Antibiotic Overuse
Epidemiological studies have demonstrated a direct relationship between antibiotic consumption and the emergence of antibiotic-resistant strains of bacteria (8). The CDC estimates that over 80 million unnecessary antibiotic prescriptions are written in the United States annually.
Inappropriate Prescribing of Antibiotics
Treatment of non-bacterial infections with antibiotics, incorrect duration of antibiotic therapy, or the wrong antibiotic agent can expedite bacterial resistance by promoting bacterial mutations and changes in gene expression. Studies have estimated that in up to half of the cases where an antibiotic is prescribed, treatment indication, choice of antibiotic, or duration of antibiotic therapy is incorrect. (8)
Agricultural Use of Antibiotics
Antibiotics are widely administered to livestock to prevent illnesses and stimulate growth. However, routine use of antibiotics in animals can contribute to bacterial resistance in the animals. Antibiotics and antibiotic-resistant bacteria are then transmitted to humans by consuming meat, further exacerbating the problem of antibiotic resistance and difficult-to-treat infections. (8)
International Travel
International travel has been deemed a significant risk factor for acquiring and spreading multidrug-resistant bacterial infections due to a lack of following safe food and hand hygiene principles and overusing antibiotics for traveler's diarrhea.
Functional Medicine Labs to Test for Root Cause of Antibiotic Resistance
The key to safely managing bacterial infections with antibiotics is correctly identifying the presence of a bacterial pathogen. Basic screening for infection includes a complete blood count (CBC), which should show an elevation of white blood cells and neutrophils in the presence of an acute, active bacterial infection. Procalcitonin is an inflammatory marker that elevates with bacterial infections and can be ordered to differentiate between viral and bacterial infections.
Standard and functional lab companies will offer antibiotic susceptibility testing with cultures, which is needed for determining the correct antibiotic agent for an identified bacterial infection. Many functional labs also test the efficacy of natural antimicrobial agents to provide alternative options for patients who prefer to avoid traditional antibiotics. Test choice will depend upon the patient's presenting symptoms; options may include a stool test for gastrointestinal symptoms, urinalysis for urinary symptoms, throat culture for respiratory symptoms, or vaginal culture for vaginal symptoms.
Functional Medicine Approaches for Antibiotic Resistance
Addressing antibiotic resistance requires the prevention of infections, improving antibiotic use, and stopping the spread of antibiotic-resistant diseases (11).
Healthcare providers can help prevent antibiotic resistance by only prescribing antibiotics when needed and targeting the medicine to the specific bacteria involved. Patients should not pressure a doctor for an antibiotic when it is unnecessary or take an antibiotic prescribed for someone else. When prescribed an antibiotic, take it exactly as prescribed without skipping doses or terminating therapy before completing the entire course. (9)
Diet for Antibiotic Resistance
Avoiding meat consumption from animals raised with antibiotics may help stop the spread of antibiotic resistance (12, 13).
Additionally, eating an anti-inflammatory, whole-food diet that is nutrient-dense and low in processed sugars can support general immune function to help manage and fight infections naturally (14).
Supplements and Herbs to Help with Antibiotic Resistance
Natural antimicrobial agents may support the management of bacterial infections. Scientific literature suggests that certain spices, herbal compounds, and natural supplements exhibit antibacterial and immune-supportive activity. Clove, cardamom, cinnamon, cumin, garlic, oregano, rosemary, and thyme are options that may help manage bacterial infections, including those resistant to some antibiotics. (15)
Many phytochemicals found naturally in plants can be used alone or in combination with antibiotics to produce synergistic antimicrobial effects. Evidence suggests that using natural compounds, including berberine, curcumin, green tea, resveratrol, and sulforaphane, may support the effectiveness of antibiotics when used together, potentially helping to manage antibiotic resistance. (16)
Vitamin C is a potent antioxidant, has supportive antimicrobial activity, and may help manage bacterial biofilms, making bacteria beneath the biofilms more accessible to antibiotics or other antimicrobial agents. (14)
Vitamin D is important for immunological signaling and immune responses against foreign pathogens. Vitamin D deficiency has been linked to increased susceptibility to infection, and supplementation has been shown to support the management of bacterial species of Pseudomonas, Helicobacter, Staphylococcus, and Streptococcus. (14, 17)
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Prevent the Spread of Infection
Good hygiene practices can help prevent the spread of bacterial-resistant infections. These include washing hands thoroughly with soap and water, not sharing food or beverages while sick, and covering the mouth when coughing or sneezing. (11, 14)
Summary
Antibiotic resistance is a global health concern leading to difficult-to-manage infections and many infection-related deaths. If you are worried about antibiotic resistance, there are daily habits you can practice to support the immune system and help prevent illness. Work with a healthcare provider when sick to discuss testing and management options appropriate for addressing the infection.
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