Antibiotic Resistance: A Growing Threat and the Role of Complementary Medicine – by Jayney Goddard MSc, PG Dip Ed, FCMA, FRSM, President, The Complementary Medical Association

I have been truly alarmed by the current shocking rise in antibiotic-resistant infections in England is a stark reminder of the global health crisis posed by antimicrobial resistance (AMR). According to the UK Health Security Agency (UKHSA), there were 66,730 severe antibiotic-resistant infections in 2023—a 7% increase compared to 2019. Rates were particularly high among England’s most deprived populations, rising by 9.5% over the same period (UKHSA, 2023). I feel it is high time for the role of complementary medical practitioners to be acknowledged by their conventional medical counterparts due to the large body of evidence that supports the efficacy of lifestyle and complementary medical interventions.

Antibiotic resistance not only compromises our ability to treat common infections but also threatens public health systems worldwide. While mainstream medicine grapples with this escalating crisis, we complementary and integrative practitioners can play a vital role in supporting patients and promoting antibiotic stewardship – and safeguarding societal health now and for the future.

The Alarming Data on Antibiotic Resistance

The English Surveillance of Antibiotic Prescribing and Utilisation Report highlighted several concerning trends:

• E. coli Infections: Over the past five years, nearly two-thirds of antibiotic-resistant bloodstream infections have been caused by Escherichia coli, a common pathogen responsible for urinary tract infections, diarrhoea, and fever. Alarmingly, 42.9% of E. coli bacteraemia isolates were resistant to co-amoxiclav, and 15.8% were resistant to third-generation cephalosporins (UKHSA, 2023).
• Carbapenemase-Producing Organisms (CPOs): Mortality rates for bloodstream infections involving CPOs reached 22.9% in 2023. Since 2021, reported cases of CPOs have doubled, reflecting a worrying trend in resistance to last-resort antibiotics (UKHSA, 2023).
• Fungal Infections: Fungaemia cases rose by 22.3% between 2019 and 2023, with Candida albicans accounting for 40% of yeast-related bloodstream infections. While resistance to key antifungals remains low, the rise in fungal infections signals the broadening scope of AMR (UKHSA, 2023).

Socioeconomic and Ethnic Disparities in Antibiotic Resistance

Antibiotic resistance disproportionately affects certain ethnic and socioeconomic groups. Rates of resistant bacteraemia were highest among Asian or Asian British communities, with 33.3 cases per 100,000 population, compared to 29.5 in White patients and 27.5 in Black patients. The overall burden of resistance in Asian communities was nearly double that of White populations (39.4% vs. 20.1%) (UKHSA, 2023).

These disparities underscore the need for targeted public health interventions and equitable access to healthcare resources.

Antibiotic Resistance Due to Use and Misuse in the NHS

Despite efforts to curb unnecessary antibiotic prescriptions, consumption has risen. Over 71% of antibiotics in 2023 were prescribed in general practice, with primary care patients’ consumption increasing by 2.4% since 2019. This rise partly reflects a surge in cases of group A Streptococcus (GAS), which required treatment with antibiotics (UKHSA, 2023).

The NHS has implemented guidelines to limit antibiotic use for conditions such as chest infections, ear infections in children, and sore throats. However, more needs to be done to address the root causes of overprescription and encourage the responsible use of antibiotics.

The Vital Role of Complementary and Integrative Medicine in Addressing Antibiotic Resistance

Complementary and integrative practitioners can contribute significantly to mitigating the antibiotic resistance crisis. By offering evidence-based lifestyle interventions, supporting immune health, and promoting patient education, we practitioners can play an essential role in antibiotic stewardship. Below are some ways we can help:

1. Strengthening Immunity Through Lifestyle Interventions
   Encouraging our clients to adopt a nutrient-rich diet, engage in regular physical activity, and manage stress effectively can bolster their immune resilience, reducing the likelihood of infections. For instance, practices such as yoga and meditation have been shown to enhance immune function (Black & Slavich, 2016).
2. Educating Patients on Antibiotic Stewardship
   Practitioners can educate our clients about the importance of following prescribed antibiotic regimens and avoiding self-medication. This education can include practical advice on when antibiotics are necessary and when alternative treatment options may suffice.
3. Providing Natural Therapies for Common Ailments
   For conditions where antibiotics are often overprescribed, such as mild respiratory infections, we practitioners are ideally positioned to recommend evidence-based alternatives. For example, honey has been shown to soothe coughs effectively, while probiotics may help prevent secondary infections during recovery (Abuelgasim et al., 2020).
4. Integrating Probiotics to Combat AMR
   Probiotics can play a dual role in supporting gut health and reducing the prevalence of antibiotic-resistant bacteria. Studies suggest that certain probiotic strains may inhibit the growth of resistant pathogens by competing for resources and producing antimicrobial compounds (Ouwehand et al., 2014).
5. Addressing Socioeconomic and Ethnic Disparities
   Complementary practitioners can work closely with underserved communities to provide accessible healthcare services. We are in an ideal position to promote health interventions, such as culturally relevant nutrition advice and wellness programmes, and these can help address disparities in antibiotic resistance outcomes.

A Call to Action

Professor Dame Jenny Harries, chief executive of the UKHSA, emphasised the importance of responsible antibiotic use and public awareness. “This isn’t just for your own health – it’s about protecting everyone in our communities and future generations,” she stated (UKHSA, 2023).

We complementary and integrative practitioners can amplify this message by fostering a holistic approach to health that prioritises prevention, education, and patient empowerment. By working alongside conventional healthcare providers, we can, together, help reduce the burden of antibiotic resistance and improve outcomes for vulnerable populations.

Finally:

The rise of antibiotic-resistant infections in England highlights an urgent public health challenge that requires a multi-faceted response. Complementary and integrative practitioners are uniquely positioned to support antibiotic stewardship through preventive care, patient education, and natural therapies. By integrating these approaches into our practices, we can contribute to a healthier future for all.

References

Abuelgasim, H., Albury, C., & Lee, J. (2021). Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis. BMJ evidence-based medicine, 26(2), 57–64. https://doi.org/10.1136/bmjebm-2020-111336

Black, D. S., & Slavich, G. M. (2016). Mindfulness meditation and the immune system: A systematic review of randomised controlled trials. Annals of the New York Academy of Sciences, 1373(1), 13-24. https://doi.org/10.1111/nyas.12998

Ouwehand, A. C., DongLian, C., Weijian, X., Stewart, M., Ni, J., Stewart, T., & Miller, L. E. (2014). Probiotics reduce symptoms of antibiotic use in a hospital setting: a randomized dose response study. Vaccine, 32(4), 458–463. https://doi.org/10.1016/j.vaccine.2013.11.053

UK Health Security Agency (UKHSA). (2023). English surveillance of antibiotic prescribing and utilisation report. UKHSA Publications.

Further Reading:

You might also wish to read our article on Integrating Complementary Therapies for an Individualised, Holistic Healthcare Future