Nazanin Vassighi, ND
Antibiotic resistance is one of the biggest public health challenges of our time, due to the rising prevalence of “superbugs,” or drug-resistant organisms (DROs). DROs may be responsible for an estimated 10 million deaths per year by 2050, surpassing cancer deaths.1 In addition to the increased risk of mortality, treatment of these infections generates a costly burden on the world economy, exceeding upwards of $100 trillion annually.2 Research and discovery of new antibiotics are outpaced by the continuing evolution of DROs. The World Health Organization (WHO) reports that advances to create newer, more powerful classes of antibiotics are decreasing due to a lack of funding and innovation, as they are costly to subsidize and slow to develop.3 In the future, routine surgical procedures may be compromised by rising incidences of DRO-related complications that lead to sepsis and, ultimately, death. Former WHO medical director, Dr Margaret Chan, has stated that we may be approaching a time when “things as common as strep throat or a child’s scratched knee could once again kill.”4 Simply put, DROs are poised to compromise the modern age of medicine and dismantle the standards of care that most global healthcare models have been built upon in the last century.
Antibiotic resistance occurs naturally through the evolution of microbes, viruses, and fungi as a means of survival in an increasingly inhospitable environment. Over-prescription of antibiotics to treat non-bacterial causes of infections, seen clinically with otitis media and upper respiratory infections (URIs), in addition to the widespread use of antibiotics in livestock, have contributed to the speed of development of resistance within the last 30 years.5 DROs are not only responsible for acute conditions, but also many stubborn chronic illnesses, such as recurrent ear, sinus, skin, and genitourinary infections. This suggests that DROs can also act opportunistically in the face of compromised immunity and a disordered microbiome. Common DROs include Methicillin-Resistant Staphylococcus aureus (MRSA), Drug-Resistant Streptococcus pneumoniae (DRSP), as well as Mycobacterium tuberculosis (MTB) and Mycobacterium avium complex (MAC). Rates of drug-resistant viruses and fungi, such as HIV and Aspergillus, are also accelerating. Some prevalent respiratory conditions affected by DROs include community-acquired pneumonia, multi-drug-resistant pulmonary tuberculosis, and chronic bronchitis.
Homeopathy & DROs
As treatment remains focused on the formulation of pathogen-specific therapies for DROs, negative treatment outcomes, including increased hospitalization rates and serious complications such as sepsis and death, continue to rise.5 It is imperative that alternative treatment regimens address this ever-growing global dilemma. Over the past 200 years, homeopathic treatment has consistently demonstrated efficacy in treating respiratory and other types of infections. Consequently, homeopathy should be utilized as a viable option to not only treat DROs, but also to reduce the dependence on antibiotic therapy as a first-line treatment. Homeopathy’s low cost, low incidence of adverse effects, and lack of interference with other medications or supplements deem it an attractive therapy, especially given the rising costs of prescription drugs. When practiced according to the rigorous, scientific criteria that Hahnemann set forth in developing this system of medicine, positive results are easily achieved. These results are evident in both in-vitro and clinical studies.
Although Streptococcus pneumoniae is the most common cause of pneumonia, severe community-acquired pneumonia cases due to MRSA are increasing in incidence, often result in hospitalization, and are also quite deadly.6 Vancomycin is currently the drug of choice for MRSA; however, vancomycin-resistant Staphylococcus aureus (VRSA) is steadily increasing, which leaves limited therapeutic options available for patients with MRSA- or VRSA-derived pneumonia.
Fortunately, homeopathic treatment of MRSA has produced some surprisingly favorable results. Passeti et al studied the ability of homeopathic Belladonna and MRSA nosode in 6C and 30C potencies to inhibit the growth of standard MRSA in culture medium.7 The remedies were also used in combination with oxacillin, a beta lactam analogue of methicillin that was commonly used to treat MRSA until its replacement by vancomycin. The remedies were tested on MRSA culture individually and in combination with each other, and all were tested against a control of 30% alcohol and water solution. Results showed that in-vitro growth of MRSA decreased significantly in both the presence of Belladonna and MRSA nosode, at both potencies.7 Interestingly, a combination of homeopathic remedies and oxacillin, at varying doses ranging from 2-16 ng/mL, significantly decreased bacterial DNAse production and reduced red blood cell lysis. This suggests that both homeopathic remedies interfere with the metabolic action of the bacteria, such that they becomes more susceptible to the action of the antibiotic to which they were previously resistant.7 The implications for this are staggering, not only in terms of improving outcomes of pneumonia due to DROs, but also in potentially reversing drug resistance.
The Research
Clinical studies of homeopathy have repeatedly demonstrated its efficacy in respiratory disease, in addition to reducing sequelae. A recent randomized, double-blind, placebo-controlled clinical trial in India was conducted on 120 patients with multi-drug-resistant tuberculosis (MDR-TB).8 Patients were randomly assigned to groups that received either a standard regimen plus individualized homeopathic medicines or a standard regimen plus placebo. Outcome measures included sputum culture analysis, imaging, lab values, and other determinants of clinical improvement. The study revealed equal sputum conversion from positive to negative in both groups; however, greater hemoglobin counts, decreased ESR values, and improvements in weight gain were seen in the group receiving standard therapy plus homeopathy.8 Additionally, patient chest X-rays revealed statistically significant improvement in 61.7% of patients in the homeopathy plus standard therapy group, versus 33.3% patients taking standard therapy alone.8
An Austrian study evaluating homeopathic treatment of septic patients showed promise in combating both short- and long-term effects of bacteremia, a common complication of DROs.9 Seventy patients with severe sepsis in the ICU were randomized to receive homeopathic treatment or placebo. All patients survived and were discharged, and other baseline demographics, such as age, preexisting conditions, and ventilation status, were not statistically significant in either group.9 Although a trend in favor of survival occurred in the homeopathic group 1 month post-discharge, it was not statistically significant. However, 6 months post-discharge, survival in the homeopathy group was statistically and significantly higher, at 75.8% versus 50.0% in the placebo group.9 These findings suggest that homeopathic treatment imparts long-term health benefits for patients by diminishing the risk of mortality. This outcome is consistent with homeopathy’s mechanism of action, ie, stimulating the Vis and treating the whole person by healing an untuned vital force, thereby rendering improvement in all organ systems and increasing patient resiliency.
As DROs place an ever-increasing financial strain on healthcare resources, clinical evidence supports homeopathy’s benefit in reducing medical expenditures for respiratory infections of all types. A review of 9 randomized controlled trials (RCTs) and 8 observational/cohort studies of homeopathic treatment of acute URIs suggested equivalent benefit to conventional treatments for uncomplicated URIs, but comparatively faster resolution from infection, reduced use of antibiotics, and possible prophylactic and longer-term benefits of homeopathy through prevention of recurrence.10
Rossi et al conducted a retrospective observational study in Italy including 105 patients, which evaluated the cost-benefit ratio of homeopathic versus conventional therapy for respiratory diseases after 2 years of homeopathic treatment. Costs of pharmaceuticals specific for respiratory disease were reduced by 46.3% and 47.5% in the first and second year of homeopathic treatment, respectively.11 In the homeopathy group, pharmaceutical drug costs among patients with recurrent respiratory infections decreased by 35.8% in the first year and by 43.6% in the second year. In contrast, drug use in the control group increased by 8.6% and 7.8% in the first year and second year, respectively. Results suggested that homeopathy is a favorable cost-saving treatment.11
Lastly, the EPI3 Cohort Study conducted in France was a 12-month, nationwide, population-based study including 825 general practitioners and 518 of their adult and child patients with URIs.12 Analysis showed that those patients who chose to consult practitioners certified in homeopathy ultimately used fewer antibiotics, antipyretics, and anti-inflammatory drugs for their respiratory complaints compared to the patients who chose practitioners who prescribe conventional medications.12
These studies substantiate clinical findings commonly observed in-office, namely that homeopathy typically shortens the intensity, frequency, and duration of respiratory disease, regardless of the type of infective organism causing it. In addition to these added health benefits, financial outcomes are improved for both patients and physicians as a result of decreased dependence on pharmaceuticals, fewer doctor visits, and decreased need for hospitalization. These factors ultimately translate to a reduction in morbidity and mortality, making homeopathy an obvious choice for a paradigm that emphasizes increased resiliency in both the patient and the healthcare system. By emphasizing the naturopathic principle of Praevenir, homeopathic treatment lessens the susceptibility of developing such types of infections rather than placing the onus on a healthcare model designed to treat the patient only after the infection develops.
Summary
As the continual emergence of DROs requires new drugs and treatment standards, it is reasonable to consider homeopathy as an effective treatment strategy for novel infections that have pandemic potential, such as the 2009 H1N1 influenza virus, the 2014 Ebola virus, or – more relevantly – the SARS-CoV-2 virus. A significant advantage of homeopathic treatment is the treatment’s focus on the person as a whole, rather than on a specific pathogen. The most correct and appropriate homeopathic remedy is dictated by the patient’s individual symptom presentation of the disease rather than by the disease itself. The benefits of a homeopathic approach were demonstrated in an Italian study conducted in April 2020. Individualized homeopathic treatment of 50 patients with confirmed positive- or probable COVID-19 resulted in resolution of cases, and with no adverse effects or need for hospitalization.13 Currently, 10 new COVID-19 trials – ranging from observational to randomized, double-blind studies – are underway, assessing homeopathic treatment and prevention of COVID-19 symptoms in Brazil, China, Cuba, India, and Iran. These studies will hopefully add more concrete evidence to an already considerable foundation of research to establish homeopathy as an effective tool in the naturopathic toolkit for novel pathogen and disease management, reversal, and improved global health outcomes.
References:
- Interagency Coordination Group on Antimicrobial Resistance. No Time To Wait: Securing The Future From Drug-Resistant Infections. Report To The Secretary-General Of The United Nations. April 2019. WHO Web site. https://www.who.int/antimicrobial-resistance/interagency-coordination-group/IACG_final_report_EN.pdf?ua=1. Accessed July 12, 2020.
- World Bank Group. Final Report. Drug Resistant Infections: A Threat to Our Economic Future. March 2017. Available at: http://documents1.worldbank.org/curated/en/323311493396993758/pdf/final-report.pdf. Accessed July 12, 2020.
- World Health Organization. Antibacterial Agents in Preclinical Development: an Open Access Database. January 2019. Available at: https://apps.who.int/iris/bitstream/handle/10665/330290/WHO-EMP-IAU-2019.12-eng.pdf. Accessed July 12, 2020.
- Chan M. Antimicrobial resistance in the European Union and the world – Keynote Address. Combatting Antimicrobial Resistance: Time for Action Conference, Copenhagen, Denmark. March 14, 2012. Available at: https://www.who.int/dg/speeches/2012/amr_20120314/en/. Accessed July 12, 2020.
- World Health Organization. Antibiotic Resistance. July 31, 2020. WHO Web site. https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance. Accessed July 13, 2020.
- Pham J, Asif T, Hamarshi MS. Community-acquired Pneumonia with Methicillin-resistant Staphylococcus Aureus in a Patient Admitted to the Intensive Care Unit: A Therapeutic Challenge. Cureus. 2018;10(1):e2019.
- Passeti TA, Bissoli LR, Macedo AP, et al. Action of antibiotic oxacillin on in vitro growth of methicillin-resistant Staphylococcus aureus (MRSA) previously treated with homeopathic medicines. Homeopathy. 2017;106(1):27-31.
- Chand KS, Manchanda RK, Mittal R, et al. Homeopathic treatment in addition to standard care in multi drug resistant pulmonary tuberculosis: a randomized, double blind, placebo controlled clinical trial. Homeopathy. 2014;103(2):97-107. [Published correction appears in Homeopathy. 2015;104(3):163.]
- Frass M, Linkesch M, Banyai S, et al. Adjunctive homeopathic treatment in patients with severe sepsis: a randomized, double-blind, placebo-controlled trial in an intensive care unit. 2005. Homeopathy. 2011;100(102):95-100.
- Fixsen A. Homeopathy in the Age of Antimicrobial Resistance: Is It a Viable Treatment for Upper Respiratory Tract Infections? Homeopathy. 2018;107(2):99-114.
- Rossi E, Crudeli L, Endrizzi C, Garibaldi D. Cost-benefit evaluation of homeopathic versus conventional therapy in respiratory diseases. Homeopathy. 2009;98(1):2-10.
- Grimaldi-Bensouda L, Bégaud B, Rossignol M, et al. Management of upper respiratory tract infections by different medical practices, including homeopathy, and consumption of antibiotics in primary care: the EPI3 cohort study in France 2007-2008. PLoS One. 2014;9(3):e89990.
- Valeri A. Symptomatic COVID-19 positive and likely patients treated by homeopathic physicians – an Italian descriptive study. Research Gate. Scientific communication to medical colleagues. April 14, 2020. Available at: https://www.researchgate.net/publication/340631586_Symptomatic_COVID-19_positive_and_likely_patients_treated_by_homeopathic_physicians_-_an_Italian_descriptive_study. Accessed July 13, 2020.
Nazanin Vassighi, ND, is a naturopathic doctor and Assistant Professor of Homeopathy at Bastyr University California (BUC). Dr Vassighi graduated from Southwest College of Naturopathic Medicine (SCNM) in Tempe, AZ. After completing a general medicine residency at SCNM, she was accepted into a specialized homeopathy residency sponsored by Standard Homeopathic under Stephen Messer, ND, DHANP. Dr Vassighi is an established speaker, and her work has been published in Homeopathy Today. In addition to teaching homeopathy at BUC, she serves as faculty supervisor at BUC Clinic, training naturopathic medical students in clinical homeopathy. For more information on Dr Vassighi, visit www.bastyrclinic.org.