Antibiotics are medicines that can stop some infections and save lives. But antibiotics can cause more harm than good when they aren't used the right way. Antibiotics only work against infections caused by bacteria. They don't work against infections caused by viruses. Viruses cause colds, the flu, and most coughs and sore throats.

Subscribe to a FREE Supplement Research Update newsletter. Once or twice a month we email a brief abstract of several studies on various supplements and natural medicine topics, including antibiotic benefit and side effect, and their practical interpretation by Ray Sahelian, M.D.

Natural antibiotic information
Many websites and health articles claim that certain herbs are natural antibiotics. It is true that many herbs, when tested in vitro, that means in a test tube in a laboratory, are found to have antimicrobial activity. However, the question remains as to whether taking an herbal supplement or eating certain herbs can act as natural antibiotics. Will a natural antibiotic kill an infection in the body? Will a natural antibiotic cure pneumonia, skin abscess, sinusitis, throat infection, ear infection, and other infections of body organs and tissues? Unfortunately very little has been published in regards to natural antibiotics and actual human studies with serious infections but some of the research appears promising. One major advantage of pharmaceutical antibiotics is that they are clearly shown to treat and cure many serious infections that would otherwise cause significant morbidity and mortality. The following are some herbs and supplements that have been promoted as having natural antibiotic potential: Garlic, colloidal silver, propolis, royal jelly, olive leaf extract, oregano, probiotics, and others. I will discuss this topic in more detail as more human studies are published on potential natural antibiotics, and as I become more convinced that in certain infections natural antibiotics offer a good and safe alternative to pharmaceutical antibiotics.

Probiotics as natural antibiotics
Probiotics can be helpful in the prevention or treatment of certain types of diarrhea and vaginal infections. Quercetin may have antiviral activity. At least one clinical trial may show quercetin to have such natural antigerm activity. See probiotic prebiotic for more information.

Antibiotic overuse and resistance
Exposure to antibiotics leads to antibiotic resistance. The development of resistance to one class of antibiotic may confer persistent increased resistance to other antibiotic classes. Thus, it is imperative that doctors are careful and judicious in their prescribing of antibiotics. The consumer also bears a responsibility not to pressure his or her doctor to prescribe antibiotics for mild symptoms or for colds and flu.

Antibiotics and asthma
Exposure to antibiotics in the first year of life may increase the risk of developing asthma later in childhood. In fact, there may even be a higher risk with each additional course of antibiotics. However, there exists the possibility of "reverse causation" -- in which the presence of asthma leads to more frequent respiratory tract infections, which in turn increases the rate of antibiotic use. The prevalence of asthma in western countries has increased over the last three decades. In the same period there has been a greater exposure of infants to antibiotics, but epidemiologic evidence linking antibiotic use with asthma risk is conflicting. Although antibiotics are commonly used to treat upper respiratory tract infections and bronchitis, most of these infections are viral -- and antibiotics are ineffective.

     An antibiotic made by French drug-maker Sanofi-Aventis may reduce some symptoms when asthma worsens but it does not improve breathing capacity. Adults who took the antibiotic telithromycin -- sold under the name Ketek -- for 10 days after their attacks show a drop in asthma symptoms. But using another gauge of success -- how much air patients could exhale -- the antibiotic showed no benefit. It does not appear that it is worthwhile to take Ketek for those who have asthma.

Antibiotics for conjunctivitis

Antibiotics are not helpful in viral conjunctivitis. Acute bacterial conjunctivitis is frequently a self-limiting condition, but the use of antibiotics is associated with improved rates of clinical and microbiological remission.

Antibiotics for COPD

in COPD exacerbations with increased cough and sputum purulence antibiotics, regardless of choice, reduce the risk of short-term mortality, decrease the risk of sputum purulence; with a small increase in the risk of diarrhea. Antibiotics are likely to be helpful in many patients with COPD exacerbations with increased cough and sputum purulence who are moderately or severely ill.

Antibiotics for cutaneous abscesses
A course of antibiotics is not required following incision and drainage of simple cutaneous abscesses.

Antibiotics for dental work
Most patients undergoing dental procedures do not need antibiotics to prevent infective endocarditis, a potentially life-threatening infection of the heart. Pre-procedure antibiotics may be required in some patients with an artificial heart valve, prior infective endocarditis, certain congenital heart defects, and a cardiac transplant complicated by heart valve dysfunction. However, even if the patient is in a high-risk group, not all dental procedures warrant preventive antibiotics. In particular, they should only be given if the procedure involves manipulation of gum tissue or parts of the teeth. Circulation, April 20, 2007.

Antibiotics for meningitis

Should children with suspected meningitis be given antibiotics before transfer to a hospital? Several European countries advise doctors in primary care to give antibiotics, but the evidence is conflicting. Two papers in the British Medical Journal (BMJ) add to this uncertainty. One shows that children who are given antibiotics before admission to hospital are more likely to die on reaching hospital. The other -- a review of all the current evidence -- cannot conclude whether or not pre-hospital antibiotics improve survival. In the first study, UK researchers analysed 158 children diagnosed with suspected meningococcal disease by a general practitioner before admission to hospital. Two thirds were given parenteral (injected) penicillin, in accordance with national guidelines. The children who were given penicillin were more likely to die than those who were not given penicillin. However, the children who received penicillin also had more severe disease on reaching hospital. So, although a harmful effect of penicillin cannot be excluded, a more likely explanation for the higher mortality is that there is a strong bias towards giving penicillin to the most severely ill children, conclude the authors. In the second paper, an international group of researchers reviewed evidence from 14 studies and found that oral antibiotics given before hospital admission were associated with reduced mortality. Results for parenteral antibiotics were inconsistent, though the data suggest that they might have a beneficial effect when a substantial proportion of patients is treated.

Antibiotics and common cold

Children suffering from a common cold and persistent runny noise should not be treated initially with antibiotics. Antibiotics can cause side effects such as vomiting, diarrhea and abdominal pain. Antibiotics should only be prescribed if the youngsters do not improve, have a high fever, and have indications for a possible bacterial infection. The overuse of antibiotics has lead to concerns about the emergence of so-called superbugs that are resistant to the most powerful antibiotics. Antibiotics should be used only when symptoms have persisted for long enough to concern parents or patients.

Cephalosoprin antibiotics

Keflex (generic name cephalexin capsules, USP, Advancis)

Fluoroquinolone antibiotic
Ciprofloxacin - Bayer Pharmaceuticals introduced the first broad spectrum oral fluoroquinolone ( Cipro, Ciproxin ) in 1988.

Tetracycline antibiotics
Tetracyclines are broad-spectrum antibiotics that act as such at the ribosomal level where they interfere with protein synthesis. They were first widely prescribed by dermatologists in the early 1950s when it was discovered that they were effective as a treatment for acne. More recently, biologic actions affecting inflammation, proteolysis, angiogenesis, apoptosis, metal chelation, ionophoresis, and bone metabolism have been researched. The therapeutic effects of tetracycline and its analogues in various diseases have also been investigated. These include rosacea, bullous dermatoses, neutrophilic diseases, pyoderma gangrenosum, sarcoidosis, aortic aneurysms, cancer metastasis, periodontitis, and autoimmune disorders such as rheumatoid arthritis and scleroderma.

Minocycline is a tetracycline antibiotic.

Ketek antibiotic

Sanofi-Aventis has an antibiotic called Ketek being tested as a treatment for ear infections and tonsillitis in nearly 4,000 infants and children in more than a dozen countries, including the United States,. The treatment was approved in 2004 for respiratory infections after the FDA rejected it in 2001 and 2003, asking for more safety information. Ketek drew renewed scrutiny in January, 2006 when researchers reported that three patients using it developed severe liver damage and one died. At the request of Europe's drug regulator that month, Sanofi included stronger warnings about potential liver disorders on product information for Ketek.
     July, 2006 - Sanofi-Aventis has added a bolded warning to the label for its antibiotic Ketek, advising doctors and patients about the potential for serious liver damage associated with the drug. The French drug maker said the U.S. Food and Drug Administration had been advised about and agreed to the changes to the prescribing information, which includes revised recommendations for the use of Ketek in patients with myasthenia gravis. Ketek, which was approved in April of 2004 to treat respiratory infections in adults, came under intense scrutiny in January after researchers reported that three patients developed severe liver damage and one died. Earlier this month, Sanofi-Aventis halted enrollment of clinical trials of Ketek in children.

Antibiotic before surgery
One dose of an antibiotic just before surgery is as good as several spread over 24 hours to fight infections at the operation site.

Antibiotic cream after surgery

An ointment containing the antibiotic mupirocin does not speed healing or prevent infection when applied to clean surgical wounds before the wound is sealed. In fact, the mupirocin ointment may increase the risk of skin edge necrosis (death). Mupirocin is effective in treating contaminated lesions and skin infections, and is widely advocated even when wounds are not contaminated, although there is little evidence to support the latter recommendation. Moreover, there are data indicating a risk of mupirocin resistance that could reduce its effectiveness over time.

Antibiotic questions
Q. While in the hospital I developed a skin rash from the use of the antibiotic Cipro and Bactrim. My doctor put me on Prednesone which took away the antibiotic rash but not entirely and I still itch. Is there an alternative supplement that will relieve this condition?
   A. We are not aware of a supplement that would take away an antibiotic induced rash or itch.