Methicillin-resistant staphylococcus aureus (MRSA)

Note
: There is currently a lack of scientific evidence for the use of integrative therapies in the treatment or prevention of methicillin-resistant Staphylococcus aureus (MRSA). The therapies listed below have been studied for bacterial infections in general, should be used only under the supervision of a qualified healthcare provider, and should not be used in replacement of other proven therapies.

A

Strong scientific evidence

• Probiotics
  : Probiotics are beneficial bacteria (sometimes referred to as "friendly germs") that help to maintain the health of the intestinal tract and aid in digestion. An increasing number of studies support the use of probiotics as a supplement to antibiotic therapy. Probiotic supplementation during a course of antibiotics may reduce the adverse effects of antibiotics in the intestinal environment. This includes reducing growth of Clostridium difficile bacteria, which can lead to colitis, a common complication of antibiotics, especially in the elderly. Some probiotics may also help prevent the development of antibiotic resistance. In acutely ill children, synbiotics have been linked to greater weight gain and fewer bacterial illnesses after antibiotics are ended. The evidence consistently supports supplementation of antibiotics. Probiotics are generally considered safe and well-tolerated. Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant.

B

Good scientific evidence

• Probiotics
  : Antibiotics are the main treatment to eradicate Helicobacter pylori, the cause of most stomach ulcers. Side effects commonly include bloating, diarrhea, and taste disturbances. Probiotics have been shown to reduce these side effects and generally help people tolerate the treatment. They may also reduce levels of H. pylori in children and adults. Yogurt containing probiotics suppresses H. pylori infection and may lead to more complete eradication during antibiotic treatment. Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant.

C

Unclear or conflicting scientific evidence

• Blessed thistle
  : Blessed thistle leaves, stems, and flowers have traditionally been used in "bitter" tonic drinks and in other preparations taken by mouth to enhance appetite and digestion. Laboratory studies report that blessed thistle (and chemicals in blessed thistle such as cnicin and polyacetylene) has activity against several types of bacteria and a lack of effect on other types. Reliable human study is currently lacking. Further evidence is necessary in this area before a firm conclusion can be drawn. Avoid if allergic to blessed thistle, mugwort, bitter weed, blanket flower, chrysanthemum, coltsfoot, daisy, dandelion, dwarf sunflower, goldenrod, marigold, prairie sage, ragweed, Echinacea or any plants of the Asteraceae or Compositae families. Use cautiously with peptic ulcer disease. Avoid with a history of bleeding diseases or gastroesophageal reflux disease (GERD), or if taking drugs for blood thinning, stroke, stomach diseases, or to control stomach acid. Avoid if pregnant or breastfeeding. Stop use two weeks before surgery/dental/diagnostic procedures with bleeding risk and do not use immediately after these procedures.
• Cranberry
  : Cranberry has been investigated for numerous medicinal uses, and promising areas of investigation include prevention of H. pylori infection and dental plaque. Study results of cranberry as an antibacterial in other conditions show conflicting results. Further study is needed before a conclusion can be drawn. Avoid if allergic to cranberries, blueberries, or other plants of the Vaccinium genus. Sweetened cranberry juice can affect blood sugar levels. Use cautiously with history of kidney stones. Avoid more than the amount usually found in foods if pregnant or breastfeeding.
• Lavender
  : Lavender is native to the Mediterranean, the Arabian Peninsula, Russia, and Africa. It has been used cosmetically and medicinally throughout history. In modern times, lavender is cultivated around the world and the fragrant oils of its flowers are used in aromatherapy, baked goods, candles, cosmetics, detergents, jellies, massage oils, perfumes, powders, shampoo, soaps, and tea. Early laboratory studies suggest that lavender oils may have antibiotic activity. However, this has not been well tested in animal or human studies. Avoid if allergic or hypersensitive to lavender. Avoid with history of seizures, bleeding disorders, eating disorders (anorexia, bulimia), or anemia (low levels of iron). Avoid if pregnant or breastfeeding.
• Prayer
  : Prayer can be defined as a "reverent petition," the act of asking for something while aiming to connect with God or another object of worship. Prayer on behalf of the ill or dying has played a prominent role throughout history and across cultures. Prayer may help reduce the length of hospital stay as well as the duration of fever in patients with infections. However, early study is controversial and additional study is needed before a conclusion can be drawn. Prayer is not recommended as the sole treatment approach for potentially serious medical conditions, and should not delay the time it takes to consult with a healthcare professional or receive established therapies. Sometimes religious beliefs come into conflict with standard medical approaches, and require an open dialog between patients and caregivers. In limited available human study, patients certain that they were receiving intercessory prayer had a higher incidence of complications following cardiac bypass surgery than those who did not know they were being prayed for.
• Probiotics
  : As a bacterial reservoir, the nose may harbor many varieties of potentially disease-causing bacteria. There is limited evidence that probiotic supplementation may reduce the presence of harmful bacteria in the upper respiratory tract. More studies are needed to establish this relationship and its implications for health. Probiotics are generally considered safe and well-tolerated. Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant.
• Propolis
  : Early study suggests that propolis may help treat various types of infections. Initial human research reports possible benefits against bacteria in the mouth, genital herpes, urine bacteria, intestinal giardia infections, or H. pylori. Additional research is needed before a recommendation can be made.
• Seaweed, kelp, bladderwrack
  : Fucus vesiculosus is a brown seaweed that grows on the northern coasts of the Atlantic and Pacific oceans, and the North and Baltic seas. Its name is sometimes used for Ascophyllum nodosum, which is another brown seaweed that grows alongside Fucus vesiculosus. These species are often included in kelp preparations along with other types of seaweed. Laboratory study suggests antifungal and antibacterial activity of bladderwrack. Reliable human studies to support use as an antibacterial or antifungal agent are currently lacking. Avoid if allergic or hypersensitive to Fucus vesiculosus and iodine. Avoid with history of thyroid disease, bleeding, acne, kidney disease, blood clots, nerve disorders, high blood pressure, stroke, or diabetes. Avoid if pregnant or breastfeeding.
• Selenium
  : Selenium is a trace mineral found in soil, water, and some foods. It is an essential element in several metabolic pathways. Preliminary research reports that selenium can be beneficial in the prevention of several types of infection, including recurrence of erysipelas (bacterial skin infection associated with lymphedema), sepsis, or Mycoplasma pneumonia. Selenium may help prevent infection by stimulating immune function. Further research is needed to confirm these results before a clear recommendation can be made. Avoid if allergic or sensitive to products containing selenium. Avoid with history of nonmelanoma skin cancer. Selenium is generally regarded as safe for pregnant or breastfeeding women. However, animal research reports that large doses of selenium may lead to birth defects.
• Sorrel
  : Historically, sorrel has been used as a salad green, spring tonic, diarrhea remedy, weak diuretic, and soothing agent for irritated nasal passages. Sorrel has been used with other herbs to treat bronchitis and sinus conditions in Germany since the 1930s. There is currently insufficient evidence to support the use of sorrel as an antibacterial. More research of sorrel alone is needed. Avoid with a known allergy to sorrel. Avoid large doses of sorrel because there have been reports of toxicity and death, possibly due to the oxalate found in sorrel. Many tinctures contain high levels of alcohol and should be avoided when driving or operating heavy machinery. High alcohol sorrel formulations may also cause nausea or vomiting when taken with the prescription drugs metronidazole (Flagyl®) or disulfiram (Antabuse®). Avoid if pregnant or breastfeeding.

D

Fair negative scientific evidence

• Macrobiotic diet
  : A macrobiotic diet has been advocated to preserve intestinal health. However, it apparently does not reduce incidence of drug-resistant bacteria in the intestinal flora, nor infections caused by resistant strains in the gastrointestinal tract, compared to a diet with animal products.
• Probiotics
  : Bacterial translocation (passage of bacteria from the gut to other areas of the body where they can cause disease) is of special concern in surgery. Limited evidence suggests that supplementation with probiotics may not reduce this problem.