The White House has just released a 63-page report that sets 1-, 3-, and 5-year goals for adderssing antibiotic resistance and overuse. The report focuses on slowing resistance, having a single point of integration for multiple health information networks, to accelerate research, testing, and treatments for current bacterial infections to stay a step ahead of the resistant bugs. By 2020, the report goals include a 50% reduction in inappropriate antibiotic use in outpatient settings, including family practices like ours.
Where do antibiotics fit into naturopathic medicine and how does this plan affect naturopathic doctors? Any treatment, including antibiotics, vaccines, and surgery can be done "naturopathically" if it is utilized within our Hierarchy of Interventions (lowest to highest, as appropriate) and if it is performed in accordance with the tenets of our profession. These pillars, discussed in earlier posts, include "treating the cause" (something antibiotics do well) and "prevention" (vaccines, check!) as well as "first, do no harm", "treating the whole person", "doctor as teacher", "wellness" and the "healing power of nature". Naturopathic medicine is not a proscribed set of herbs or nature therapies to the exclusion of advances in medicine, it is a philosophy that takes these tenets into account when treating each patient as an individual. Sometimes, antibiotics are the right choice. Sometimes, an herbal remedy with antimicrobial properties would be a better, lower-level intervention for a less serious bacterial illness. NDs (naturopathic doctors) work to support the patient's own immune system in addition to appropriate interventions to address the cause of the illness, whether it is lifestyle-related, genetic, bacterial, viral, fungal, or environmental.
As a parent, it is difficult to take a sick child into the doctor and NOT come out with something tangible, like a prescription for antibiotics. Many doctors feel pressured to "do something" by the parents, aside from recommending rest and hydration. However, antibiotics do not address causes that are not bacterial, such as viruses, and should not be given unless there is a strong indication for need. In addition, there are a number of antimicrobial or antibacterial herbs that can be used in place of antibiotics in milder illnesses. Many viral illnesses are self-limiting and sometimes the best thing we can do is to support the immune system with natural antivirals (like elderberry and licorice) and help to relieve symptoms that are the body's way of attacking the virus (cough suppressants like cherry bark for example). Common hygiene practices, such as proper hand-washing technique, can slow or stop the spread of viruses and bacteria in many cases. Naturopathic medicine has multiple treatment choices that can help minimize our reliance on antibiotics, allowing them to be reserved for more serious bacterial infections and slowing the progression of antibiotic resistance. It is my hope that some of that research money will be used to replicate earlier studies on antimicrobial herbs as an alternative to antibiotics for resistant bugs.