Integrative medicine, as defined by the American Board of Integrative Medicine® and the Academic Consortium for Integrative Medicine & Health, is the practice of medicine that reaffirms the importance of the relationship between practitioner and patient. It focuses on the whole person, is informed by evidence, and it makes use of all appropriate therapeutic approaches, healthcare professionals, and disciplines to achieve optimal health and healing.
CAM systems are whole medical systems, complete systems of theory and practice that have evolved independently over time in different cultures and apart from conventional medicine or Western medicine. Some of these systems are practiced by individual cultures for millennia before the development of natural science-based, conventional medicine.
Examples of these CAM systems are found in Asia, where for example TCM exists for more than 4,000 years and where ayurveda is practiced for more than 3,000 years in India. Other CAM systems have developed next to conventional medicine within the western cultures. For example in Europe, homeopathy is practiced since the middle of the 18th century, and anthroposophic medicine (AM), and naturopathy since the early 20th century. CAM prevention and treatment strategies have been developed on the basis of their holistic worldviews and longstanding traditional use, long before the application of results of epidemiologic studies into (evidence-based) medicine.
The main CAM preventive strategies are lifestyle measures or interventions and medical measures or interventions. Their aim is to improve the physiological ability to self-manage and adapt to infections.
The main treatment (curative) strategies of CAM are the medicinal and non-pharmaceutical treatments that support the organism to overcome the infection by itself by means of strengthening the self-regulating abilities of the organism.
Antimicrobial resistance is the broader term for resistance in different types of microorganisms and encompasses resistance to antibacterial, antiviral, antiparasitic and antifungal drugs.
Antimicrobial resistance occurs naturally but is facilitated by the inappropriate use of medicines, for example using antibiotics for viral infections such as cold or flu, or sharing antibiotics.
Resistance to antimicrobials (AMR) is a complex and growing, international public health problem. [1, 2] Globally, infections with resistant microorganisms are estimated to kill hundreds of thousands of people every year. An often cited but also criticized scenario suggests that by 2050 that figure could be more than 10 million. The economic cost will also be significant, with the world economy being hit by up to $100 trillion by 2050 if we do not take action. [1]
Formal policies on the global, regional and national level most often use six strategies to reduce antibiotic use:
However, currently these strategies appear to be insufficient, as for example demonstrated by the unchanged average European consumption rates of antibiotics during the years 2011 – 2014. [4] European statistics also show that there are significant differences between European countries which are not related to geographic or natural conditions and can only be explained by socio-economic factors (policies, values, competencies, …). [5] For example, in the UK in 2015, for the first time fewer antibiotics were being prescribed by GPs and clinicians across all healthcare settings than in 2014. [6] Nevertheless, the latest “EARS-Net data for 2016 show that antimicrobial resistance remains a serious threat to public health in Europe”. [7]
[1] O’Neill, J., Tackling drug-resistant infections globally: final report and recommendations. Review on Antimicrobial Resistance 2016. Publications. html.
[2] EMA. Antimicrobial resistance. 2017; Available here.
[3] World Health Organization, Global action plan on antimicrobial resistance. 2015. ISBN, 2017. 978(92): p. 4.
[4] Smith, E., et al., Evaluation of the EC action plan against the rising threats from antimicrobial resistance. 2016.
[5] Gaygısız, Ü., T. Lajunen, and E. Gaygısız, Socio-economic factors, cultural values, national personality and antibiotics use: A cross-cultural study among European countries. Journal of infection and public health, 2017. 10(6): p. 755-760.
[6] Hopkins, S. and A. Johnson, English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) 2016. 2016.
[7] ECDC. Summary of the latest data on antibiotic resistance in the European Union. 2017; Available here.