A Spoonful of Sugar Helps the Medicine go Down

I recently completed a section in my Pharmacology class on Antibiotics. As a Naturopathic Medical student, I feel I am well versed on the consequences of overusing antibiotics. The overuse has increased significantly in the last several years, resulting in strong bacterial resistance, among other health concerns.

Our bodies are so resistant to antibiotics, that certain bacteria are now existing in a subpopulation known as ‘persisters’. These dormant cells tolerate antibiotic treatment and are thought to be the underlying cause of recurrent infections. Persistent bacteria have been implicated in biofilms and in chronic and recurrent infections. Currently there are no known methods for eradicating persisters, however, clinical evidence is supporting the use of specific metabolic stimuli which would enable the lysis of these bacteria. The preferred method? Sugar.

The study published in Nature treated Urinary Tract Infections (UTI) caused by persistent bacteria in mice. It was found that mice that were treated with sugar combined with an aminoglycoside antibiotic, like gentamicin, recovered from UTIs. The form of sugar used made a difference in the outcome; the study used fructose, sucrose and mannitol. If the sugar is digested before it reaches the infected site, it is virtually useless. Mannitol, however, can not be digested by humans and was found to be a viable metabolic stimulant.

Mannitol was first introduced to me in Botanical Medicine II as a supplement to include when prescribing herbs for Urinary Tract Infections. Mannitol can be used clinically to stimulate diuresis by exerting an osmotic draw for sodium, potassium and water. In fact, mannitol is found in urinary herbs like Elymus repens (Quackgrass), which is a diuretic, demulcent and antimicrobial. Quackgrass contains 2-3% Mannitol and it is effective because once ingested, bacteria will stop reproducing to consume the Mannitol, allowing the diuretic action of the herb to flush out the bacteria.

This research interests me for several reasons; not only does it address a serious clinical problem dealing with resistant bacteria, but it also draws from something that Naturopath’s have clinically understood for some time. Our training is stronger in plants and botanicals that that of an Allopathic education. By learning about the active constituents in plants and their clinical applications, we are equally versed in understanding clinical research not only from a Naturopathic standpoint, but also as Physicians and colleagues.

References:
Time Healthland
Stanford University – Biofilms
Nature

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