Infection

Checklist for Infection

Rating	Nutritional Supplements	Herbs
	Vitamin A Vitamin C	Andrographis Licorice
	Glutamine (for prevention of post exercise infection in performance athletes) Multiple vitamin-mineral (for elderly people) Multiple vitamin–mineral supplement (for diabetics) Probiotics Selenium (for elderly people and to prevent hospital-acquired infections in very low birth weight infants) Zinc	Echinacea Licorice (for viral infections)
		American ginseng Asian ginseng Astragalus Barberry Chaparral Coriolus Elderberry Eleuthero Eucalyptus Garlic Goldenseal Green tea Lemon Balm (antiviral) Ligustrum Lomatium Maitake Myrrh Olive leaf Onion Oregano Oregon grape Osha Pau d’arco (for fungal infection only) Picrorhiza Reishi Rosemary Sage Sandalwood Schisandra Shiitake St. John’s Wort Tea tree oil (topical) Thyme Usnea Wild Indigo
See also: Homeopathic Remedies for Infection
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

Medical treatments

Over the counter agents available to treat minor bacterial skin infections include benzalkonium chloride (Zephiran®), neosporin (Myciguent®), bacitracin (Baciguent®), and combination antibiotic formulas (Neosporin®, Polysporin®). Fungal skin infections may be treated with clotrimazole (Lotrimin AF®), miconazole (Micatin®), and terbinafine (Lamisil®). Drugs used to treat vaginal yeast infections include clotrimazole (Gyne-Lotrimin®, Mycelex®), miconazole (Monistat®), and butoconazole (Femstat 3®). Individuals with infections that do not respond to over the counter medications should seek medical advice.

Prescription strength topical, oral, and intravenous antibiotic medicines are reserved for more serious bacterial infections; these include cephalosporins, such as cephalexin (Keflex®), cefaclor (Ceclor®), and cefazolin (Ancef®); lincosamides, such as lincomycin (Lincocin®) and clindamycin (Cleocin®); macrolides, such as erythromycin (Ery-Tab®), clarithromycin (Biaxin®), and azithromycin (Zithromax®); penicillins, such as penicillin VK (Veetids®), amoxicillin (Amoxil®), and dicloxacillin (Dynapen®); and sulfonamides, such as sulfasoxazole (Gantrisin Pediatric®) and sulfamethoxazole (Gantanol®, Septra®, Bactrim®). Antiviral drugs are available to treat infections caused by herpes simplex and human immunodeficiency virus (HIV). Numerous drugs are available to treat topical and systemic infections caused by fungus and yeast.

Surgical treatment is recommended in some cases to remove diseased tissue, prevent the spread of infection, or drain pus from an infected area.

Nutritional supplements that may be helpful

Nutrients useful for maintaining healthy immune function are also applicable for preventing infections. Vitamin A plays an important role in immune system function and helps mucous membranes, including those in the lungs, resist invasion by microorganisms.¹² However, most research shows that while vitamin A supplementation helps people prevent or treat infections in developing countries where deficiencies are common,¹³ little to no positive effect, and even slight adverse effects, have resulted from giving vitamin A supplements to people in countries where most people consume adequate amounts of vitamin A.¹⁴ ¹⁵ ¹⁶ ¹⁷ ¹⁸ ¹⁹ ²⁰ Moreover, vitamin A supplementation during infections appears beneficial only in certain diseases. An analysis of trials revealed that vitamin A reduces mortality from measles and diarrhea, but not from pneumonia, in children living in developing countries.²¹ A double-blind trial for vitamin A supplementation in Tanzanian children with pneumonia confirmed its lack of effectiveness for this condition.²² In general, parents in the developed world should not give vitamin A supplements to children unless there is a reason to believe vitamin A deficiency is likely, such as the presence of a condition causing malabsorption (e.g., celiac disease). However, the American Academy of Pediatrics recommends that all children with measles should be given high-dose vitamin A for several days.

Vitamin C has antiviral activity, and may help prevent viral infections²³ or, in the case of the common cold, reduce the severity and duration of an infection.²⁴ Most studies on the common cold used 1 to 4 grams of vitamin C per day.

Lactobacillus acidophilus (the friendly bacteria found in yogurt) produces acids that kill invading bacteria.²⁵ The effective amount of acidophilus depends on the strain used, as well as the concentration of viable organisms. These and other friendly bacteria known as probiotics inhibit the growth of potentially infectious organisms (pathogens) by producing acids, hydrogen peroxide, and natural antibiotics called bacteriocins and microcins, by utilizing nutrients needed by pathogens, by occupying attachment sites on the gut wall that would otherwise be available to pathogens, and by stimulating immune attacks on pathogens. Infections that have been successfully prevented or treated with friendly bacteria include infectious diarrhea, vaginitis, and urinary tract infections.²⁶

Marginal deficiencies of zinc result in impairments of immune function.²⁷ Supplementation with 50 mg of zinc three times per day for 30 days has been shown to increase immune function in healthy people.²⁸ However, such large amounts of zinc can potentially cause adverse effects. Some doctors recommend lower amounts of supplemental zinc for people experiencing recurrent infections, such as 25 mg per day for adults and even lower amounts for children (depending on body weight). Zinc lozenges have been found helpful in some studies for the common cold. Zinc has not been studied as prevention or treatment for other types of infection.

A multiple vitamin-mineral formula helped elderly people avoid infections in one double-blind trial, but not in another.²⁹ ³⁰ In a double-blind study of middle-aged and elderly diabetics, supplementation with a multiple vitamin and mineral preparation for one year reduced the risk of infection by more than 80%, compared with a placebo.³¹ In another double-blind trial, supplements of 100 mcg per day of selenium and 20 mg per day of zinc, with or without additional vitamin C, vitamin E, and beta-carotene, reduced infections in elderly people, though vitamins without minerals had no effect.³² That study suggests that trace minerals may be the most important components of a multiple vitamin and mineral formula for preventing infections.

Premature infants with very low birth weight have an increased susceptibility to infections. In a double-blind trial, premature infants were given either selenium supplements (5–7 mcg per 2.2 pounds of body weight) or placebo. Those receiving the selenium supplements had fewer hospital-acquired infections.³³

Athletes who undergo intensive training or participate in endurance races (such as a marathon) are at increased risk of developing infections. In a double-blind study, marathon runners received either glutamine (5 grams immediately after the race and 5 grams again two hours later) or a placebo. Compared with the placebo, supplementation with L-glutamine reduced the incidence of infections over the next seven days by 62%.³⁴

Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.

References

1. Sanchez A, Reeser JL, Lau HS, et al. Role of sugars in human neutrophilic phagocytosis. Am J Clin Nutr 1973;26:1180–4.

2. Ahmed FE. Toxicological effects of ethanol on human health. Crit Rev Toxicol 1995;25:347–67.

3. Kubena KS, McMurray DN. Nutrition and the immune system: A review of nutrient-nutrient interactions. J Am Diet Assoc 1996;96:1156–64.

4. Horesh AJ. Allergy and infection VII. Support from the literature. J Asthma Res 1968;6:3–55 [review].

5. Pang LQ. The importance of allergy in otolaryngology. Clin Ecology 1982;1:53.

6. Nsouli TM, Nsouli SM, Linde RE, et al. Role of food allergy in serous otitis media. Ann Allergy 1994;73:215–9.

7. Horesh AJ. Allergy and recurrent urinary tract infections in childhood. II. Ann Allergy 1976;36:174–9.

8. Crandall, M. Allergic predisposition and recurrent vulvovaginal candidiasis. J Advancement Med 1991;4:21–38 [review].

9. Kudelco N. Allergy in chronic monilial vaginitis. Ann Allergy 1971;29:266–7.

10. McIntosh WA, Kaplan HB, Kubena KS, et al. Life events, social support, and immune responses in elderly individuals. Int J Aging Hum Dev 1993;37:23–36.

11. Nieman DC. Exercise, upper respiratory tract infection, and the immune system. Med Sci Sports Med 1994;26(2):128–39.

12. Semba RD. Vitamin A, immunity, and infection. Clin Infect Dis 1994;19:489–99 [review].

13. Glasziou PP, Mackerras DEM. Vitamin A supplementation in infectious diseases: a meta-analysis. BMJ 1993;306:366–70.

14. Stephensen CB, Franchi LM, Hernandez H, et al. Adverse effects of high-dose vitamin A supplements in children hospitalized with pneumonia. Pediatrics 1998;101(5):E3 [abstract].

15. Bresee JS, Fischer M, Dowell SF, et al. Vitamin A therapy for children with respiratory syncytial virus infection: a multicenter trial in the United States. Pediatr Infect Dis J 1996;15:777–82.

16. Quinlan KP, Hayani KC. Vitamin A and respiratory syncytial virus infection. Serum levels and supplementation trial. Arch Pediatr Adolesc Med 1996;150:25–30.

17. Kjolhede CL, Chew FJ, Gadomski AM, et al. Clinical trial of vitamin A as adjuvant treatment for lower respiratory tract infections. J Pediatr 1995;126:807–12.

18. Pinnock CB, Douglas RM, Badcock NR. Vitamin A status in children who are prone to respiratory tract infections. Aust Paediatr J 1986;22:95–9.

19. Murphy S, West KP Jr, Greenough WB 3d, et al. Impact of vitamin A supplementation on the incidence of infection in elderly nursing-home residents: a randomized controlled trial. Age Ageing 1992;21:435–9.

20. Fawzi WW, Mbise R, Spiegelman D, et al. Vitamin A supplements and diarrheal and respiratory tract infections among children in Dar es Salaam, Tanzania. J Pediatr 2000;137:660–7.

21. Ross AC. Vitamin A supplementation as therapy—are the benefits disease specific? Am J Clin Nutr 1998;68:8–9 [review].

22. Fawzi WW, Mbise RL, Fataki MR, et al. Vitamin A supplementation and severity of pneumonia in children admitted to the hospital in Dar es Salaam, Tanzania. Am J Clin Nutr 1998;68:187–92.

23. Geber WF, Lefkowitz SS, Hung CY. Effect of ascorbic acid, sodium salicylate, and caffeine on the serum interferon level in response to viral infection. Pharmacology 1975;13:228–33.

24. Hemila H. Vitamin C and the common cold. Br J Nutr 1992;67:3–16.

25. Fernandes CF, Shahani KM, Amer MA. Therapeutic role of dietary lactobacilli and lactobacillic fermented dairy products. FEMS Micro Rev 1987;343–56.

26. Mombelli B, Gismondo MR. The use of probiotics in medical practice. Int J Animicrob Agents 2000;16:531–6 [review].

27. Fraker PJ, Gershwin ME, Good RA, Prasad A. Interrelationships between zinc and immune function. Fed Proc 1986;45:1474–9.

28. Duchateau J, Delespesse G, Vereecke P. Influence of oral zinc supplementation on the lymphocyte response to mitogens of normal subjects. Am J Clin Nutr 1981;34:88–93.

29. Chandra RK. Effect of vitamin and trace-element supplementation on immune responses and infection in elderly subjects. Lancet 1992;340:1124–7.

30. Chavance M, Herbeth B, Lemoine A, et al. Does multivitamin supplementation prevent infections in healthy elderly subjects? A controlled trial.Int.J Vitam Nutr Res 1993;63:11–6.

31. Barringer TA, Kirk JK, Santaniello AC, et al. Effect of a multivitamin and mineral supplement on infection and quality of life. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 2003;138:365–71.

32. Girodon F, Lombard M, Galan P, et al. Effect of micronutrient supplementation on infection in institutionalized elderly subjects: a controlled trial. Ann Nutr Metab 1997;41:98–107.

33. Darlow BA, Winterbourn CC, Inder TE, et al. The effect of selenium supplementation on outcome in very low birth weight infants: a randomized controlled trial. The New Zealand Neonatal Study Group. J Pediatr 2000;136:473–80.

34. Castell LM, Newsholme EA. The effects of oral glutamine supplementation on athletes after prolonged, exhaustive exercise. Nutrition 1997;13:738–42.

What are the symptoms of infection?

Medical treatments

Dietary changes that may be helpful

Lifestyle changes that may be helpful

Nutritional supplements that may be helpful

Herbs that may be helpful

References