Antibiotics alternatives, how well do they work? Are there effective natural alternative remedies?
July 16 2018
by Ray Sahelian, M.D.


Antibiotics are medicines that can stop some infections and save lives. But they can cause more harm than good when they aren't used the right way. They 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. Too many kids are still getting antibiotic prescriptions for colds, viral sore throats, and other illnesses that don't require or respond to these medications.

Natural antibiotic alternative 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 and kill bacteria. 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.

Garlic and onion have some antibiotic properties.

Eur J Microbiology mmunology (Bp). 2014. Saponins increase susceptibility of vancomycin-resistant enterococci to antibiotic compounds.

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. Also consider garlic as an alternative in some cases of minor infections and you can find an article on potential natural alternatives in an effort to kill unwanted bacteria in the body.

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.

Antibiotic-resistant bacteria associated with livestock in workers at industrial farms where animals are kept in confinement and given these medications to promote their growth.

Overuse of antibiotics in Europe is building widespread resistance and threatening to halt vital medical treatments such as hip replacements, intensive care for premature babies and cancer therapies. Antibiotics are needed in all these treatments to prevent bacterial infection. But drug-resistant bacteria are a growing problem in hospitals worldwide, marked by the rise of superbugs such as methicillin-resistant Staphylococcus aureus (MRSA).

Allergy to antibiotics send more than 140,000 people to U.S. emergency rooms each year, another reason for doctor to reduce the number of prescriptions written, especially for viral infections such as colds.

Side effects, danger, risk, safety
Even seemingly gentle ones disrupt the balance of microbes living in the gut, with unforeseen health consequences. An intimate study of three women given ciprofloxacin showed the drug suppressed entire populations of beneficial bacteria, and at least one woman took months to recover. The study, published in the Proceedings of the National Academy of Sciences in 2010, supports the common wisdom that antibiotics can damage the "good" germs living in the body.

Taking the widely used antibiotic clarithromycin may boost some patients' odds of dying from heart-related causes.

Children treated with antibacterial drugs face a greater risk for developing juvenile arthritis.

Problems in infants
Using certain antibiotics early in infancy may raise the risk of a serious gastrointestinal condition called pyloric stenosis. Doctors have known that using the antibiotic erythromycin can increase the risk of pyloric stenosis in infants. Nw findings confirm that link, and also found that the antibiotic azithromycin (Zithromax) is associated with a higher risk of pyloric stenosis when given to infants under 6 weeks old.

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.

JAMA. 2014 Dec 24-31. Antibiotics for acute bronchitis. Are antibiotics associated with improved outcomes in patients with acute bronchitis? Prescribing antibiotics for acute bronchitis was associated with reduced overall and nighttime cough and with an approximately half-day reduction in duration of cough, in days feeling ill, and in days with impaired activities. However, at follow-up, there were no significant differences in patients receiving antibiotics compared with those receiving placebo in overall clinical improvements or limitations in work or other activities. There was a significant increase in adverse effects in the antibiotic group, particularly gastrointestinal symptoms.


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.


COPD and lung disease, infection

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 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.


Diabetes risk
Taking antibiotics might increase the risk of developing type 2 diabetes. Danish researchers found that people with type 2 diabetes tended to take more antibiotics in the years leading up to their diagnosis than Danes without the condition; Aug. 27, 2015, online Journal of Clinical Endocrinology & Metabolism.


Those with joint replacements
In early 2009, the American Academy of Orthopedic Surgery (AAOS) safety committee recommended that dentists consider antibiotic prophylaxis for all patients with total joint replacement before any dental procedure but this recommendation should be reversed. Dr. Elie F. Berbari of the Mayo Clinic College of Medicine in Rochester, Minnesota, found no association between dental procedures, with or without antibiotic prophylaxis, and the risk of total hip or knee infection. Dr. Elie F. Berbari says, "The risk of seeding a prosthesis from bacteria in the blood is certainly there, but routine activities such as toothbrushing, flossing, and chewing are much more likely to cause this seeding than transient bacteremia after a dental procedure. Antibiotic prophylaxis is not needed for all patients with joint replacement prior to any dental procedure. Clin Infect Dis 2010.


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.


Those with the common cold and respiratory illness are more likely to get antibiotics - which don't work for these conditions - when they visit an urgent care clinic.


Cephalosoprin antibiotics

Keflex (generic name cephalexin capsules, USP, Advancis)


Fluoroquinolone antibiotic
Fluoroquinolone antibiotics are prescribed often and include moxifloxacin (Avelox; Bayer), delafloxacin (Baxdela; Melinta Therapeutics), ciprofloxacin (Cipro; Bayer), gemifloxacin (Factive; Merus Labs), levofloxacin (Levaquin; Janssen), and ofloxacin.


Ciprofloxacin - Bayer Pharmaceuticals introduced the first broad spectrum oral fluoroquinolone ( Cipro, Ciproxin ) in 1988. People taking fluoroquinolones may be at a small risk of an eye condition called retinal detachment. There is an increased risk of tendinitis and tendon rupture.



The Food and Drug Administration warns about side effects related to mental health and the risk for low blood sugar, including hypoglycemic coma.

The FDA continues its warning in 2013 that fluoroquinolones cause sudden, serious, and potentially permanent nerve damage called peripheral neuropathy.


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.


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.


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.


Q. Is there a reason why most doctors recommend 10 days for antibiotics" Why not less or more?
   A. Each infection is different depend on type and severity, but many doctors now are realizing that most cases of not severe infections can be treated with less than 10 days.

I have chronic broncotis with yellow to green phlegm. A Z pak worked for 17 years , but no longer works. Any suggestion of something without sulfite which causes me to have an anaphylactic reaction and throat constriction.
    I can't provide individual suggestions but perhaps some of the information on the immune page will help.


Recently due to bouts with chest congestion, I have been prescribed two antibiotics; Zithromax and or Eeythromycin. As a natural medicine devotee, I have had a not so pleasant experience with ERY-TABS. I would like your advice on natural medicines that are just as effective in treating bacteria Bronchitis as comparable to the medications. I am a working journalist and need to continue my work on a daily basis without any down time related to the side effects of the prescribed medications.
    I am not aware of herbs that treat bacterial bronchitis but you could review the page on the immune system. The U.S. Food and Drug Administration in 2013 reported that the antibiotic azithromycin, sold as Zithromax or Zmax, can cause a fatal irregular heart rhythm in some patients.


We continue to hear of antibiotic resistance, particularly clarithromycin, but I have not seen any epidemiological studies evaluating this in the literature. Are you aware of any studies or individuals involved in this type of research.
    I focus on natural supplements and have not kept up in detail with this topic as much as an infectious medicine specialist.