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Antibiotic Resistance

Story at-a-glance -

  • Commonly prescribed antibiotics may make certain antibiotic-resistant infections, like MRSA, worse
  • Up to 50 percent of pathogens that cause surgical site infections, and 25 percent of those that cause infections following chemotherapy, are already resistant to common antibiotics
  • If antibiotic effectiveness drops by another 10 percent, it could result in 40,000 more infections and 2,100 additional deaths following surgery and chemotherapy each year
 

Antibiotic Resistance Is Only Going to Get Worse

November 25, 2015 | 40,717 views

By Dr. Mercola

Most of you reading this are fortunate enough to have lived all or most of your life in a world with access to antibiotics.

For all of their downfalls and risks, having access to effective antibiotics can save your life – preventing a minor wound from spreading a life-threatening infection, for instance, and allowing for potentially life-threatening conditions, like pneumonia, to be effectively treated.

The problem is that antibiotic's primary target – bacteria – is smart. Even under the best circumstances, bacteria can eventually adapt to resist and overpower once-effective antibiotics.

In recent decades, however, the overuse and misuse of antibiotics has greatly sped up this process, and we're now seeing what it's like to live in a post-antibiotic era. According to the World Health Organization (WHO):1

"WHO's 2014 report on global surveillance of antimicrobial resistance revealed that antibiotic resistance is no longer a prediction for the future; it is happening right now, across the world, and is putting at risk the ability to treat common infections in the community and hospitals.

Without urgent, coordinated action, the world is heading towards a post-antibiotic era, in which common infections and minor injuries, which have been treatable for decades, can once again kill."

Treating Superbugs With Antibiotics May Make People Sicker

In the U.S., at least 2 million people are infected with antibiotic-resistant bacteria every year, and at least 23,000 die as a result.2 This is already a staggering number, but the problem is slated to get worse.

A 2015 report commissioned by UK Prime Minister David Cameron estimated that by 2050, antibiotic resistance will have killed 300 million people, with the annual global death toll reaching 10 million, and the global cost for treatment reaching $100 trillion.

A mere 15 years from now, in the year 2030, antibiotic-resistant disease — if left to spiral out of control — is expected to have killed 100 million.3 One of the most common, and formidable, antibiotic-resistant pathogens in the US is MRSA (methicillin-resistant Staphylococcus aureus).

MRSA is a cause of skin infections that can spiral out of control, leading to bloodstream infections, pneumonia, infections at surgical sites, and even death. In the US, more than 80,000 invasive infections and 11,000 deaths are caused by MRSA each year.

Current national guidelines set by the Infectious Diseases Society of America call for antimicrobial treatment of MRSA, but this only highlights how little is actually known about how to treat resistant superbugs.

New research published in the journal Cell Host & Microbe revealed that commonly prescribed antibiotics may actually make MRSA infections worse.4

In the study, beta-lactam antibiotics (similar to methicillin) caused the MRSA bacteria in treated mice to build inflammatory cell walls leading to tissue damage.

In typical staph infections, such antibiotics work by neutralizing enzymes that build cell walls.One of the enzymes, PBP2A, was not neutralized by the antibiotics, however, and enabled MRSA to continue building cell walls. MRSA also had an altered cell wall structure that allowed it to spread.5

The researchers found that overall, when MRSA-infected mice were treated with the antibiotics, they became even sicker.

Superbugs Leading to Increased Deaths From Surgery, Chemotherapy

With the effectiveness of many common antibiotics growing more questionable by the day, researchers estimated that tens of thousands of Americans may be vulnerable to life-threatening infections following surgery or chemotherapy.

The study, a review of previously published research, estimated that up to 50 percent of pathogens that cause surgical site infections, and 25 percent of those that cause infections following chemotherapy, are already resistant to common antibiotics.6

If antibiotic effectiveness drops by even another 10 percent, it could result in 40,000 more infections and 2,100 additional deaths following surgery and chemotherapy each year.

A 30 percent drop in effectiveness could mean another 120,000 infections and 6,300 deaths annually, the researchers concluded.7 Worse still, if antibiotic effectiveness declines by 70 percent, the US could see 280,000 more infections and 15,000 more deaths as a result.

The study focused on surgeries and chemotherapies that often involve prophylactic antibiotics, such as hip fracture surgery, cesarean section, colorectal surgery, and transrectal prostate biopsy, and chemotherapy for the treatment of blood cancers.

Joshua Wolf, an infectious disease researcher at St. Jude's Children's Research Hospital in Memphis, Tennessee, told Reuters:

"As antibiotic resistance rates rise, it is inevitable that prophylaxis will become less effective… It is very likely that surgical procedures will become less safe for patients… Treatment for cancer would also become more challenging as antibiotic resistant bacteria become more prevalent."

Antibiotic-Resistant Gonorrhea on the Rise

Gonorrhea is increasingly becoming resistant to available drug treatments, and as such may soon pose a major public health threat. Antibiotic-resistant gonorrhea first emerged when I was in medical school in the late 1970s. By the 1980s, the antibiotics penicillin and tetracycline were no longer effective against it.

Next, gonorrhea resistant to fluoroquinolone antibiotics emerged, leaving only one class of antibiotic drugs, cephalosporins, left to treat it. Now, as you might suspect, gonorrhea is fast becoming resistant to cephalosporins – the last available antibiotics to treat it.

In 2013, the US Centers for Disease Control and Prevention (CDC) estimated that about one-third of gonorrhea cases were resistant to at least one antibiotic. They updated treatment guidelines to include a dose of the antibiotic ceftriaxone along with a second antibiotic.

The two-pronged treatment appeared to be working, pushing resistance rates from 1.4 percent in 2011 to 0.4 percent in 2013. However, according to the latest CDC data, published in JAMA, "improvements in susceptibility may be short-lived."8,9

From 2013 to 2014, cases of resistant gonorrhea doubled, with rates reaching 0.8 percent. WHO already recognizes drug-resistant gonorrheaas "an emergency," with several countries, including Australia, France, Japan, Norway, Sweden, and the United Kingdom, experiencing increasing infections.

Antibiotics Increase Sudden Cardiac Death Risks

Part of the problem with antibiotics overuse and misuse is that some people, including even some physicians, assume it can't hurt to take a course just in case. But many people aren't aware that antibiotics have a risk of serious side effects.

Macrolide antibiotics (azithromycin [Zithromax], clarithromycin [Biaxin], quinolone, and erythromycin), for instance, increase your risk of sudden cardiac death. In a meta-analysis of nearly 21 million people, the drugs were linked to a small but significant increase in the heart risk.

For every 1 million treatment courses, the use of macrolide antibiotics resulted in an additional 36 sudden cardiac deaths.10 Macrolides are widely used in the treatment of bronchitis, pneumonia, ear infections, and sexually transmitted diseases.

Past research has also highlighted their risk of side effects. Azithromycin, for instance, increases your chances of dying from a cardiovascular event by a whopping 250 percent within the first five days of usage compared to taking amoxicillin.11

One Course of Antibiotics May Disrupt Your Microbiome for a Year

The impact of antibiotic usage on our microbiome is one of the most important considerations yet has received little attention. Antibiotics are indiscriminate bactericidal agents, meaning they kill all bacteria, both beneficial and pathologic, and many of the immediate and long-term side effects are related to this fact.

By killing off the bacteria in your gut, antibiotics have a detrimental effect on your overall immune system, as about 80 percent of your immune system resides in your gastrointestinal tract. In fact, research published in MBio found just one course of antibiotics negatively alters your microbiome for up to a year.12 According to the researchers:

"We followed the oral and gut microbiomes in 66 individuals from before, immediately after, and up to 12 months after exposure to different antibiotic classes. The salivary [oral] microbiome recovered quickly and was surprisingly robust toward antibiotic-induced disturbance.

The fecal microbiome was severely affected by most antibiotics: for months, health-associated butyrate-producing species became strongly underrepresented. Additionally, there was an enrichment of genes associated with antibiotic resistance.

Clearly, even a single antibiotic treatment in healthy individuals contributes to the risk of resistance development and leads to long-lasting detrimental shifts in the gut microbiome."

This is precisely why it's crucial to only use antibiotics when absolutely necessary. And when you do use them, be sure to "reseed" your gut with beneficial bacteria, either in the form of a probiotics supplement or fermented foods. If you don't, your immune function, and more, can remain compromised for some time.

Evidence Lacking for Use of Fluoroquinolone Antibiotics

Fluoroquinolones, such as Cipro and Avelox, are among the most dangerous drugs on the market. Despite their dangers, they're the most commonly prescribed class of antibiotics in the United States. In 2013, the US Food and Drug Administration (FDA) finally issued a warning that fluoroquinolone antibiotics, taken by mouth or injection, carry a risk for permanent peripheral neuropathy.

Peripheral neuropathy is nerve damage in the arms and/or legs, characterized by "pain, burning, tingling, numbness, weakness, or a change in sensation to light touch, pain, or temperature, or sense of body position."

Fluoroquinolones have fluoride as a central part of the drug, which is part of what makes them so dangerous. Fluoride is a known neurotoxin, and drugs with an attached fluoride molecule are able to penetrate into very sensitive tissues, including your brain.

The ability to cross the blood-brain barrier is what makes fluoride such a potent neurotoxin. Fluoride also disrupts collagen synthesis, and can damage your immune system by depleting energy reserves and inhibiting antibody formation in your blood.

In 2015, the Antimicrobial Drugs Advisory Committee and the Drug Safety and Risk Management Advisory Committee also voted that evidence to support some uses of fluoroquinolones is lacking. Specifically, the panel voted data does not support the use of these antibiotics for:

  • Acute bacterial sinusitis
  • Acute bacterial exacerbation of chronic bronchitis in people with chronic obstructive pulmonary disease (COPD)
  • Uncomplicated urinary tract infections

While the FDA does not have to accept the recommendations of its committees, the vote may trigger the FDA to require new label language or even revoke approval for these indications. The panel also received notice that the FDA Adverse Events Reporting System (FAERS) had received 178 reports of a "constellation of symptoms" leading to disability associated with the drugs.

The emerging cases of fluoroquinolone-associated disability (FQAD) could indicate that the drugs are causing harm through an unknown mechanism that goes beyond the generally known adverse effects.13

The Antibiotics in Your Food May Also Promote Resistance

Antibiotic overuse and inappropriate use in humans bear a heavy responsibility for creating the superbug crisis we are facing today. But, the pervasive misuse of antibiotics by the agriculture industry also plays a very significant role. Agriculture accounts for about 80 percent of all antibiotics used in the US. Compare this to the 6 million pounds of antibiotics that are used for every man, woman, and child in the US combined.

CAFOs (concentrated animal feeding operations), in particular, are hotbeds for breeding antibiotic-resistant bacteria because of the continuous feeding of low doses of antibiotics to the animals, which allows pathogens to survive, adapt, and eventually, thrive.

According to the CDC, 22 percent of antibiotic-resistant illness in humans is in fact linked to food,14 but a more accurate statement might be linked to food from CAFOs. Take Klebsiella pneumonia, a bacteria that can lead to pneumonia, bloodstream infections, wound and surgical site infections, and meningitis. Klebsiellaare often found in the human intestinal tract, where they are normally harmless.

But, if your immune system is compromised and you get exposed to an especially virulent drug-resistant form of Klebsiella, the consequences to you can be deadly. It wasn't thought to be transmitted via food… until now. Research published in the journal Clinical Infectious Diseases showed that turkey, chicken, and pork sold in US grocery stores may contain klebsiella pneumonia.15

How to Avoid Becoming Another Victim to Antibiotic-Resistant Disease

You can help yourself and your community by only purchasing antibiotic-free meats and other foods and using antibiotics only when absolutely necessary. This is an important step that I urge everyone to take, even though ultimately the problem of antibiotic-resistance needs to be stemmed on a global level. That said, your lifestyle choices are the most critical factors in determining the health of your immune system, which determines your ability to resist infections.

The stronger your immune defenses, the less chance a microbe – antibiotic-resistant or otherwise -- will have of gaining a foothold in some part of your body. Below are some basic strategies for supercharging your immune system. You may also want to download my free special report about how to protect yourself from super germs.

  • Optimize your diet. Avoid foods that tax your immune system such as synthetic trans fats, fried foods, processed foods, sugar, and grains; reduce carbohydrates (sugar, grains, and fructose) and protein, replacing them with high-quality fats. Fifty to 70 percent of your total intake should be fat.
  • Most of your diet should be fresh, whole foods, like organic vegetables, grass-pastured meats and dairy, and beneficial fats, such as butter and fermented dairy from grass-pastured animals, cheese, egg yolks, and avocados.

    A great portion of your immune system resides in your GI tract, which depends on a healthy, balanced gut flora. One of the best ways to support this is by incorporating naturally fermented foods into your diet, working up to four to 6 ounces per day.

    One large serving of several ounces of fermented foods can supply you with around 10 trillion beneficial bacteria, which is about 10 percent of the population of your gut. You can take a high-quality probiotic supplement, but the actual fermented foods offer the greatest benefit.

  • Exercise regularly. Exercise improves the circulation of immune cells in your blood. The better these cells circulate, the more efficient your immune system is at locating and eliminating pathogens in your body. Make sure your fitness plan incorporates weight training, high-intensity exercises, stretching, and core work.
  • Get plenty of restorative sleep. Recent research shows sleep deprivation has the same effect on your immune system as physical stress or disease, which is why you may feel ill after a sleepless night.
  • Have good stress-busting outlets. High levels of stress hormones can diminish your immunity, so be sure you're implementing some sort of stress management. Meditation, prayer, yoga, and Emotional Freedom Techniques (EFT) are all excellent strategies for managing stress, but you'll have to find what works best for you.
  • Optimize your vitamin D levels. Studies have shown that inadequate vitamin D can increase your risk for MRSA and other infections, which can likely be extended to other superbugs. Your best source of vitamin D is through exposing your skin to the sun or using a safe tanning bed. Monitor your vitamin D levels to confirm they're in the therapeutic range, 50 to 70 ng/ml. If you can't get UV exposure, consider taking an oral vitamin D supplement.

In addition to the basic lifestyle measures listed above, there are natural agents that science has shown to be naturally antibacterial. The following deserve special mention.

  • Vitamin C. Vitamin C's role in preventing and treating infectious disease is well established. Intravenous vitamin C is an option, but if you don't have access to a practitioner who can administer it, liposomal vitamin C is the most potent oral form. For more information on vitamin C, listen to my interview with Dr. Ronald Hunninghake, an internationally recognized vitamin C expert. If you choose to use supplement vitamin C, liposomal C seems to be the best form to use.
  • Garlic. Garlic is a powerful antibacterial, antiviral, and antifungal. It can stimulate your immune system, help wounds heal, and kill antibiotic-resistant bacteria (including MRSA and multi-drug resistant tuberculosis), plus has shown more than 100 other health promoting properties.16 For highest potency, the garlic should be eaten fresh and raw (chopped or smashed.)
  • Olive leaf extract. In vitro studies show olive leaf extract is effective against Klebsiella, a gram-negative bacteria, inhibiting its replication, in addition to being toxic to other pathogenic microbes.
  • Manuka honey. Manuka honey, made from the flowers and pollen of the Manuka bush, has been shown to be more effective than antibiotics in the treatment of serious, hard-to-heal skin infections. Clinical trials have found Manuka honey can effectively eradicate more than 250 clinical strains of bacteria, including resistant varieties such as MRSA.
  • Tea tree oil. Tea tree oil is a natural antiseptic proven to kill many bacterial strains (including MRSA).17
  • Colloidal silver. Colloidal silver has been regarded as an effective natural antibiotic for centuries, and recent research shows it can even help eradicate antibiotic-resistant pathogens. If you are interested in this treatment, make sure you read the latest guidelines for safe usage of colloidal silver as there are risks with using it improperly.
  • Copper. Replacing fixtures with certain copper alloys can help kill bacteria, even superbugs. Installing copper faucets, light switches, toilet seats, and push plates in germ-infested areas such as hospitals and nursing homes could potentially save thousands of lives each year.

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