Non-antibiotic therapies for infectious diseases.

The emergence of multiple antibiotic resistant organisms in the general community is a potentially serious threat to public health. The emergence of antibiotic resistance has not yet prompted a radical revision of antibiotic utilisation. Instead it has prompted the development of additional antibiotics. Unfortunately, this does not relieve the underlying selection pressure that drives the development of resistance. A paradigm shift in the treatment of infectious disease is necessary to prevent antibiotics becoming obsolete and, where appropriate, alternatives to antibiotics ought to be considered. There are already several non-antibiotic approaches to the treatment and prevention of infection including probiotics, phages and phytomedicines. There is some evidence that probiotics such as Lactobacillus spp. or Saccharomyces boulardii are useful in the prevention and treatment of diarrhoea, including Clostridium difficile-associated diarrhoea that can be difficult to treat and recurs frequently. Bacteriophages have received renewed attention for the control of both staphylococcal and gastrointestinal infections. Phytomedicines that have been utilised in the treatment of infections include artesunate for malaria, tea tree oil for skin infections, honey for wound infections, mastic gum for Helicobacter pylori gastric ulcers and cranberry juice for urinary tract infections. Many infections may prove amenable to safe and effective treatment with non-antibiotics.