Bacteria, viruses, fungi, and parasites are evolving to resist the antimicrobials that were developed to kill them. The primary cause of Antimicrobial Resistance (AMR) is misused/overused, excessive and inappropriate use of antimicrobials.
New Zealand has had comparatively low rates of antimicrobial resistance but we now have rising rates of AMR strains of Escherichia coli, Neisseria gonorrhoeae and Staphylococcus aureus.1
The Ministry of Health commissioned the Williamson et al. 2016 study which reported a high level of antibiotic dispensing in New Zealand when compared with many European countries, which increased almost 50% from 2006 to 2014,2 followed by a 14% drop between 2015 and 2018.3
New Zealand has the fourth highest antibiotic use of OECD countries and, just as the rest of the world, faces a rising tide of AMR. However, having some of the highest rates of human antimicrobial consumption in the world, New Zealand still lacks national guidance or strategy to support judicious antimicrobial use in humans, animals, and plants, and a system to monitor their use.4
New Zealand isn’t operating with evidence-based guidelines despite the 2017 AMR Action Plan calling for a national standard in human and in animal health, and coordinated surveillance programme of antimicrobial drug use.5 Prescribers are not required to record the reason for an antimicrobial drug, and have no national AMR prescribing guidelines.6
AMR can also develop from household cleaning and hygiene products, and herbicides. Studies have found antimicrobials in our environment but the contamination impacts are understudied. Varroa mites were resistant to two common miticides within ten years of detection in New Zealand bees, and pathogens resistant to common copper-based plant antifungals and the antibiotic streptomycin have been reported. MPI reported a 14% increase in plant antibiotics purchases between 2017 and 2018. Antimicrobial drug use for animals is low in New Zealand compared with other countries, and highest on pig and poultry farms however, there is no data on the volume of their use in pig versus poultry.7
Nearly 1,000 New Zealanders were infected with methicillin-resistant Staphylococcus aureus (MRSA) in 2017, with certain urinary tract infections, and gonorrhoea, due to AMR.8
Gonorrhoea was classified as a notifiable disease in New Zealand on 04 January 2017 where prevalence nearly doubled between 2013 and 2019.9 Caused by Neisseria gonorrhoeae it can affect the urethra, reproductive tract and organs, anus, throat, and eyes, and when left untreated can cause pelvic inflammatory disease, pregnancy complications, female infertility, inflammation of the epididymis, male sterility, and eye infections.10
In 2016, New Zealand had 146 cases per 100,00011 12with most detected in 15–29-year-olds,13 with prevalence increasing from 165 to 289 cases per 100,000 among Māori from 2014 and 2019.14 Heterosexual women (27%) and men who have sex with men (26%) account for the greatest proportion of cases.15 However, it is estimated that more than half of gonorrhea infections are unidentified or unreported even with well established reporting systems.16
N. gonorrhoeae has developed wide ranging AMR, with resistance to sulphonamide drugs first reported in the 1940’s. Current circulating New Zealand strains are resistant to some but not all antimicrobials, and overseas trends suggest untreatable aka ‘super gonorrhoea’ will develop in New Zealand.17 No multi- or extensively drug resistant strains were identified in samples from 2014 and 2015, nor between 2018 and 2019, but ‘premultidrug-resistant’ strains were.18
With exceptions of azithromycin and tetracycline, N. gonorrhoeae AMR during 2018 – 2019 remained stable or had decreased in New Zealand since 2014-15.19 Auckland hospital data reported 2016 AMR rates to ciprofloxacin (22%), penicillin (21%), and tetracycline (42%) far in exceedance of the recommended 5% threshold for the use of these agents.20
WHO issued a 2019 warning that N. gonorrhoeae was progressively developing AMR to all therapeutic antibiotics, and untreatable gonorrhoea is on the horizon.21 N. gonorrhoeae is a high-priority pathogen as there are no obvious antimicrobials left to use against gonorrhoea when the current recommended treatments start to fail. Unsurprisingly, in 2021 the WHO released its preferred product characteristics for a potential N. gonorrhoeae vaccine.22
Homeopathy shows potential for significant reduction in antibiotic use232425 and further methodologically high-quality human and veterinary homeopathy studies are urgently needed due to the global AMR threat. Effectiveness of homeopathy in general, in particular treatment of infections, is adequately proven for further research in this field.2627
In farm animal medicine, homeopathy is favoured by organic farmers who rightly perceive the downsides of conventional drugs28 due to their disadvantages which include ineffectiveness, toxicity, transference into meat and milk, and contribution to antimicrobial and anthelmintic resistance.29 Way back, in 1999, Homeopathy was reported to be the main alternative to antibiotics on UK organic farms, accounting for 50% of mastitis treatments.30
In Australia, the annual direct cost for Urinary Tract Infections (UTI) is approximately AUD 909 million,31 and hospital admissions due to Escherichia coli induced UTI estimated to cost AUD 2.3 million annually.32
Uropathogenic AMR particularly in E. coli,33 rose steadily during 2013–201734 and is now a major problem associated with effective UTI treatment.35 Trimethoprim, routinely prescribed in Australia for uncomplicated UTI,36 has rising rates of resistance,37 with a 34% rise in resistance detected in UK samples in 2016 alone.38
Bactericidal effects of homeopathic medicines against E. coli have been observed in in vitro3940414243 and animal models.444546
Although bactericidal effect via homeopathic medicine has been shown, this is not in accordance with the general principles of homeopathy with its hypothesis that the individualized homeopathic medicine affects the host, by, for example, activation of the immune system to prevent hospitality to, and adhesion of, bacteria rather than by direct bactericidal or bacteriostatic effects.
Theoretically, Individualized Homeopathy (IH) can mitigate recurring infections47 and has been shown to reduce recurring UTI,48 and upper respiratory tract infections.49 Retrospective case series have shown IH to be an effective approach in the management of AMR recurrent UTIs5051 able to reduce the frequency and antibiotic use in women.52 Two case reports (of mine) outline reduced antibiotic use in chronic suppurative otitis media53 and recurrent pneumonia.54
A wee anecdote regarding Dr. John Paterson’s own preparation, the bowel nosode Sycotic Co., which caused him embarrassment during WWII when his clinic at No. 923 was not so much a bacteriologist's consulting room, as a venereal disease (VD) clinic where people, usually from Foreign Forces Contingents, would present at all hours. Dr. J lost his temper sending a soldier away amid much reproach from Dr. E Paterson, his wife and colleague, who reminded him he could not treat suffering humanity so. Later, there was a phone call from a senior Medical Officer (MO) asking for an appointment, and who arrived with the man Dr. J turned away who "had all the pain an acute epididymitis can give, and all the inflammation." Dr. J still refused to treat him. The senior MO, stating the cases Dr. J had treated resolved and gave no more trouble, was provided a large supply of Sycotic Co. and reportedly thereafter No. 923 was no longer a VD clinic. Dr. J always regarded Sycotic Co. as a possible remedy where the individual had respiratory, intestinal or reproductive system catarrh.55
Homeopathic medicine is not out to kill - it supports our inherent defense systems to overcome pathologies56 enabling us to exist in improved harmony within ourselves, our surroundings, and the world of bacteria and micro-organisms.
Further reading on homeopathy & AMR reporting by Sarah Penrose:
Athletes and antibiotic resistance
Ministry of Health and Ministry for Primary Industries 2017. Available from: https://www.health.govt.nz/publication/new-zealand-antimicrobial-resistance-action-plan
Williamson DA, Roos RF, Verrall A. 2016. Antibiotic Consumption in New Zealand, 2006–2014. Prepared for the Ministry of Health. Porirua: Institute of Environmental Science and Research Ltd. Available from: https://surv.esr.cri.nz/PDF_surveillance/AntibioticConsumption/2014/Antibiotic_Consumption_Report_Final. pdf
The Office of the Prime Minister’s Chief Science Advisor. 2021. Kotahitanga Uniting Aotearoa against infectious disease and antimicrobial resistance. Full report. Auckland. Available from: https://bpb-ap se2.wpmucdn.com/blogs.auckland.ac.nz/dist/f/688/files/2022/06/OPMCSA-AMR-Full-report-FINAL-V3-PDF.pdf
The Office of the Prime Minister’s Chief Science Advisor. 2021. Kotahitanga Uniting Aotearoa against infectious disease and antimicrobial resistance. Full report.
Ministry of Health and Ministry for Primary Industries. 2017. Antimicrobial Resistance: New Zealand’s current situation and identified areas for action. Wellington. Available from: https://www.health.govt.nz/system/files/documents/publications/antimicrobial-resistance-nz-situation-areas-for-action-mar17.pdf
The Office of the Prime Minister’s Chief Science Advisor. 2021. Kotahitanga Uniting Aotearoa against infectious disease and antimicrobial resistance. Full report.
The Office of the Prime Minister’s Chief Science Advisor. 2021. Kotahitanga Uniting Aotearoa against infectious disease and antimicrobial resistance. Full report.
The Office of the Prime Minister’s Chief Science Advisor. 2021. Kotahitanga Uniting Aotearoa against infectious disease and antimicrobial resistance. Full report.
The Office of the Prime Minister’s Chief Science Advisor. 2021. Kotahitanga Uniting Aotearoa against infectious disease and antimicrobial resistance. Full report.
Lee, J.S., Choi, H.Y., Lee, J.E., et al. (2002). Gonococcal keratoconjunctivitis in adults. Eye, 16(5), 646-649. https://doi.org/10.1038/sj.eye.6700112
Institute of Environmental Science and Research Limited (ESR). (2021). Sexually transmitted infection (STI) surveillance (dashboard). Available from https://www.esr.cri.nz/our-services/consultancy/public-health/sti/
Institute of Environmental Science and Research Limited (ESR). (2019). Sexually transmitted infections in New Zealand annual surveillance report 2016. Porirua, NZ: ESR. Available from:https://surv.esr.cri.nz/PDF_surveillance/STISurvRpt/2016/FINAL_2016_STI_AnnualReport.pdf
Institute of Environmental Science and Research Limited (ESR). (2021). Sexually transmitted infection (STI) surveillance (dashboard).
The Office of the Prime Minister’s Chief Science Advisor. 2021. Kotahitanga Uniting Aotearoa against infectious disease and antimicrobial resistance. Full report.
Straub, C., Thirkell, C., & Dyet, K. 2021. Antimicrobial resistance and molecular epidemiology of Neisseria gonorrhoeae in New Zealand, 2018-2019. Porirua, New Zealand: Institute of Environmental Science and Research Ltd. Available from: https://surv.esr.cri.nz/PDF_surveillance/Antimicrobial/Gono/NgonoSurvey2019_FINAL.pdf
Leichliter et al., 2020. Trends in factors indicating increased risk for STI among key subpopulations in the United States, 2002-2015. Sex Transm Infect. Mar;96(2):121-123. Available from: https://pubmed.ncbi.nlm.nih.gov/31350378/
The Office of the Prime Minister’s Chief Science Advisor. 2021. Kotahitanga Uniting Aotearoa against infectious disease and antimicrobial resistance. Full report.
Lee et al. 2018. Genomic epidemiology and antimicrobial resistance of Neisseria gonorrhoeae in New Zealand. Journal of Antimicrobial Chemotherapy, 73(2), 353-364. https://doi.org/10.1093/jac/dkx405
Heffernan, H., Woodhouse, R., & Williamson, D. 2015. Antimicrobial resistance and molecular epidemiology of Neisseria gonorrhoeae in New Zealand, 2014-15. Porirua, NZ: Institute of Environmental Science and Research Ltd.
Institute of Environmental Science and Research Limited (ESR). 2019. Sexually transmitted infections in New Zealand annual surveillance report 2016.
Unemo et al., 2019. World Health Organization Global Gonococcal Antimicrobial Surveillance Program (WHO GASP): review of new data and evidence to inform international collaborative actions and research efforts. Sex Health. Sep;16(5):412-425. Available from: https://pubmed.ncbi.nlm.nih.gov/31437420/
World Health Organization. 2021. WHO preferred product characteristics for gonococcal vaccines. Geneva, Switzerland: World Health Organization. Retrieved from https://www.who.int/publications/i/item/9789240039827
Van der Werf et al., 2018. Do NHS GP surgeries employing GPs additionally trained in integrative or complementary medicine have lower antibiotic prescribing rates? Retrospective cross-sectional analysis of national primary care prescribing data in England in 2016. BMJ Open. Mar 5;8(3):e020488. Available from: https://pubmed.ncbi.nlm.nih.gov/29555793/
Fixsen. 2013. Should homeopathy be considered as part of a treatment strategy for otitis media with effusion in children? Homeopathy. Apr;102(2):145-50. Available from: https://pubmed.ncbi.nlm.nih.gov/23622265/
Bell and Boyer. 2013. Homeopathic medications as clinical alternatives for symptomatic care of acute otitis media and upper respiratory infections in children. Glob Adv Health Med. Jan;2(1):32-43. Available from: https://pubmed.ncbi.nlm.nih.gov/24381823/
Beer et al., 2021. Homöopathie in der medizinischen Versorgung. Gesundh. Ökon. Qual. Manag. 2021;26:245–247. Available from https://www.researchgate.net/publication/354672226_Homoopathie_in_der_medizinischen_Versorgung_Konsens_10_Experten_-_10_Statements
Weiermayer et al., 2020. Evidenzbasierte Veterinär-/Homöopathie und ihre mögliche Bedeutung für die Bekämpfung der Antibiotikaresistenzproblematik – ein Überblick [Evidence-based homeopathy and veterinary homeopathy, and its potential to help overcome the anti-microbial resistance problem - an overview]. Schweiz Arch Tierheilkd. Oct;162(10):597-615. German, French. Available from https://pubmed.ncbi.nlm.nih.gov/33006555/ Synopsis at https://cam-europe.eu/evidence-based-homeopathy-and-veterinary-homeopathy/
Lees et al., 2017. Comparison of veterinary drugs and veterinary homeopathy: part 2. Vet Rec. Aug 19;181(8):198-207. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5738588/
Toutain et al., 2016. Veterinary Medicine Needs New Green Antimicrobial Drugs. Front Microbiol. Aug 3;7:1196. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4971058/
Hovi & Roderick, 1999. An investigation of the incidence, treatment strategies and financial implications of mastitis in organic and conventionally managed UK dairy herds Report to Defra, OF0124T. Reading, UK, Reading: p 19 pp https://www.cabdirect.org/cabdirect/abstract/20000406390
OUTBREAK consortium. 2020. A One Health antimicrobial resistance economic perspective [online]. Sydney, Australia. https://outbreakproject.com.au/wp-content/uploads/2020/12/OUTBREAK_REPORT_2020_economics_ERRATUM.pdf
Lee et al., 2021. Attributable Length of Stay, Mortality Risk, and Costs of Bacterial Health Care-Associated Infections in Australia: A Retrospective Case-cohort Study. Clinical Infectious Diseases [online]. May 18;72(10):e506-e514. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130032/
Davey et al., 2020. Management of urinary tract infection by early-career general practitioners in Australia. Journal of Evaluation in Clinical Practice [online]. Dec;26(6):1703-1710. https://pubmed.ncbi.nlm.nih.gov/31875655/
Australian Commission on Safety and Quality in Health Care (ACSQHC). 2019. AURA 2019: third Australian report on antimicrobial use and resistance in human health [online]. Sydney, Australia. https://www.safetyandquality.gov.au/sites/default/files/2019-06/AURA-2019-Report.pdf
Chandra et al., 2020. Promising Roles of Alternative Medicine and Plant-Based Nanotechnology as Remedies for Urinary Tract Infections. Molecules [online]. Nov 28;25(23):5593. https://pubmed.ncbi.nlm.nih.gov/33260701/
SA Health. 2021. Antimicrobial Guidelines. Government of South Australia [online]. Adelaide, Australia. https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/clinical+resources/clinical+programs+and+practice+guidelines/medicines+and+drugs/antimicrobial+guidelines/antimicrobial+guidelines
Fasugba et al., 2016. Five-Year Antimicrobial Resistance Patterns of Urinary Escherichia coli at an Australian Tertiary Hospital: Time Series Analyses of Prevalence Data. PLoS One [online]. Oct 6;11(10):e0164306. https://pubmed.ncbi.nlm.nih.gov/27711250/
NICE. 2017. National Institute for Health and Care Excellence (online). London, United Kingdom. https://www.nice.org.uk/news/article/antibiotic-resistance-is-now-common-in-urinary-tract-infections
Nader et al., 2023. Dynamized Aloysia Polystachya (Griseb.) Essential Oil: A Promising Antimicrobial Product. Homeopathy. May;112(2):120-124. Available from: https://pubmed.ncbi.nlm.nih.gov/35768002/
Munshi R, Talele G, Shah R. 2022. In-Vitro Evaluation of Antimicrobial Activities of Escherichia coli, Klebsiella pneumoniae, Salmonella typhi, Neisseria gonorrhoeae, and Candida albicans Nosodes. Homeopathy. Feb;111(1):42-48. Available from: https://pubmed.ncbi.nlm.nih.gov/34020481/
Buchheim-Schmidt et al., 2021. In vitro evaluation of the anti-pathogenic activity of Okoubaka aubrevillei on the human gastrointestinal tract. Zeitschrift fur Gastroenterologie [online]. May;59(5):423-437. English. https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-1404-3344
Munshi et al., 2021. In-Vitro Evaluation of Antimicrobial Activities of Escherichia coli, Klebsiella pneumoniae, Salmonella typhi, Neisseria gonorrhoeae, and Candida albicans Nosodes. Homeopathy [online]. May 21. https://pubmed.ncbi.nlm.nih.gov/34020481/
De et al., 2012. Potentiated homeopathic drug Arsenicum Album 30C inhibits intracellular reactive oxygen species generation and up-regulates expression of arsenic resistance gene in arsenite-exposed bacteria Escherichia coli. Zhong Xi Yi Jie He Xue Bao [online]. Feb;10(2):210-27. https://pubmed.ncbi.nlm.nih.gov/22313889/
Jaguezeski AM, Glombowsky P, da Rosa G, Da Silva AS. 2021. Daily intake of a homeopathic agent by dogs modulates white cell defenses and reduces bacterial counts in feces. Microb Pathog. Jul;156:104936. Available from: https://pubmed.ncbi.nlm.nih.gov/33951540/
Jaguezeski et al., 2021. Daily intake of a homeopathic agent by dogs modulates white cell defenses and reduces bacterial counts in feces. Microbial Pathogenesis [online]. Jul;156:104936. https://pubmed.ncbi.nlm.nih.gov/33951540/
de Paula Coelho et al., 2017. Homeopathic medicine Cantharis modulates uropathogenic E. coli (UPEC)-induced cystitis in susceptible mice. Cytokine [online]. Apr;92:103-109. https://pubmed.ncbi.nlm.nih.gov/28142108/
Vithoulkas G, Carlino S. 2010. The "continuum" of a unified theory of diseases. Medical Science Monitor [online]. Feb;16(2):SR7-15. https://pubmed.ncbi.nlm.nih.gov/20110932/
Pannek et al., 2019. Usefulness of classical homeopathy for the prophylaxis of recurrent urinary tract infections in individuals with chronic neurogenic lower urinary tract dysfunction. The Journal of Spinal Cord Medicine [online]. Jul;42(4):453-459. https://pubmed.ncbi.nlm.nih.gov/29485355/
Fixsen A. 2018. Homeopathy in the Age of Antimicrobial Resistance: Is It a Viable Treatment for Upper Respiratory Tract Infections? Homeopathy. May;107(2):99-114. Feb 5. Available from: https://pubmed.ncbi.nlm.nih.gov/29767829/
Chand KS, Kapoor P. 2020. Two Case Reports of Integrated Management of Antibiotic-Resistant Urinary Tract Infection. Homeopathy [online]. May;109(2):97-106. Available from: https://pubmed.ncbi.nlm.nih.gov/31958866/
Bagot JL, Stahl G. A Case of Recurrent Urinary Tract Infection Successfully Treated during Homeopathic Supportive Care in Oncology. Homeopathy. 2023 Aug;112(3):205-212. doi: 10.1055/s-0042-1758554. Epub 2023 Feb 1. PMID: 36724815.
Gaertner et al., 2020. Individualized Homeopathic Treatment in Women with Recurrent Cystitis: A Retrospective Case Series. Complementary Medicine Research [online]. 27(3):193-199. https://pubmed.ncbi.nlm.nih.gov/31945769/
Brown, G. 1967; Drs. John and Elizabeth Paterson; Br. Hom. J.. Vol. 56, pp. 201-218. Vermuelen F. Monera, Spectrum of the Natural Kingdoms, Bacteria & Viruses. The Netherlands: Emryss bv Publishers. 2005.
Mahesh S, Denisova T, Gerasimova L, Pakhmutova N, Mallappa M, Vithoulkas G. 2020. Multimorbidity After Surgical Menopause Treated with Individualized Classical Homeopathy: A Case Report. Clin Med Insights Case Rep. Oct 19;13:1179547620965560. Available from: https://pubmed.ncbi.nlm.nih.gov/33149716/