You may have heard about the White House report, “National Action Plan for Combating Antibiotic-Resistant Bacteria.” It is a victory that this issue is on our national agenda. As an infectious disease physician, I have seen the life-saving and life-improving capabilities of appropriate antibiotic therapies many times. I have also seen, however, the emergence of drug resistance in bacteria occurring over several decades. It has accelerated such in the past decade that we now see patients with bacteria that are resistant to all our usual antibiotic choices, and have to resort to toxic antibiotics used in the past, or sometimes no antibiotic at all. The CDC estimates that drug-resistant bacteria cause two million illnesses and approximately 23,000 deaths each year in the US alone. In case you haven’t read all 62 pages of the report, I am highlighting some of it here.
The goals of the National Action Plan (NAP) are:
Slow the Emergence of Resistant Bacteria and Prevent the Spread of Resistant Infections
Strengthen National One-Health Surveillance Efforts to Combat Resistance
Advance Development and Use of Rapid and Innovative Diagnostic Tests for Identification and Characterization of Resistant Bacteria
Accelerate Basic and Applied Research and Development for New Antibiotics, Other Therapeutics, and Vaccines
Improve International Collaboration and Capacities for Antibiotic-resistance Prevention, Surveillance, Control, and Antibiotic Research and Development.
Our medical specialty of Infectious Diseases is thrilled to see this multi-pronged approach, and we have long advocated for judicious use of antibiotics and accelerated pathways for new antimicrobials. As an essential oiler, I would like to focus on goals #1 and #4.
#1 - Slow the Emergence of Resistant Bacteria and Prevent the Spread of Resistant Infections
While many of the multi-drug resistant pathogens we see are in the hospital, the bulk of human antibiotic prescribing in the US is done for outpatients. It is estimated that 50% of antibiotic use may be unnecessary. In 2010, 258 million courses of antibiotics were prescribed, or 833 prescriptions per 1000 persons. The CDC’s campaign “Get Smart: Know When Antibiotics Work” educates the public and health providers that antibiotics aren’t always the answer. For many common illnesses like viruses and flu, antibacterials will not help and can have harmful side effects, in addition to increasing drug-resistant bacteria. We in the oily community are already aware that antibiotics are not always the best answer, and we use essential oils that have been shown to have some antimicrobial activity to fend off impending infection and also use oils to relieve symptoms of infection when they occur. The NAP calls for monitoring of antibiotic use to assure appropriate use in both outpatient and inpatient settings. In addition to this, wouldn’t it be great for providers and patients to know about the benefits of essential oils?
Surprisingly, 70% of antibiotics used in the US are given to livestock and poultry. While the plan falls short of adopting antibiotic-free meats, the plan does recommend that more is done to decrease the use of antibiotics important to humans in growth promotion for animals. Kudos to Chipotle, Panera, and Chik-Fil-A for deciding to buy antibiotic-free meats, and to McDonald’s for plans to stop using chicken raised with antibiotics important to humans! This is progress.
#4 - Accelerate Basic and Applied Research and Development for New Antibiotics, Other Therapeutics, and Vaccines
This is where goal #4 comes in. While there will be emphasis on developing new antibiotics, the goal also aims to identify new therapeutics. And get this (from page 44 of NAP):
“Examples of non-traditional therapeutic strategies include:
Identifying natural compounds with antibiotic activity (e.g., phytochemicals, essential oils, organic acids, animal-derived lytic enzymes, and small interfering RNAs).”
So you see, essential oils are mentioned in the National Action Plan to combat antibiotic resistance! And why not? There is already in vitro (laboratory) data and we know of many anecdotes. We are just lacking clinical trials to demonstrate effectiveness in humans. I found this mention of the oils in the National Action Plan very exciting. We oilers are ahead of the game!
New vaccines for pathogens that become drug-resistant are also included as a therapeutic strategy and this is important. Vaccines are one of the most significant public health developments of the 20th century and the more we can prevent infections, the less we have to use antibiotics!
So, the National Action Plan is a step in the right direction and even suggests developing alternatives such as essential oils. While we love the benefits of our oils, it is no shame to use antibiotics when we do need them. It is about using all the tools available to you—and using the right one at the right time!
References for more information:
Hicks LA, Taylor Jr TH. U.S. Outpatient Antibiotic Prescribing, 2010. N Engl J Med 2013;368:15
Get Smart: Know When Antibiotics Work. http://www.cdc.gov/getsmart/community/index.html
Chao SC, Young DG, Oberg CJ. Effect of a diffused essential oil blend on bacterial bioaerosols. J Essent Oil Res 1998;10:517-23.