Perhaps one of the most impressive and potentially valuable properties of cannabidiol or CBD is its powerful antibacterial characteristics.
Effective antibiotics have been one of the main pillars that has allowed us to reap the benefits of modern medicine – allowing us to live longer and healthier than ever before. Unfortunately, we currently live in an age where the improper and overuse of antimicrobials in humans and animals is causing rising drug resistance, and this in turn, is giving rise to superbugs – or dangerous strains of bacteria that are adapting to survive after coming into contact with an antibiotic.
The idea of superbugs may sound like something out of a science fiction movie, but it would be foolish for people to dismiss this danger. You see, antibiotics increase selective pressure in bacterial populations, causing vulnerable bacteria to die, and thus increasing the percentage of resistant bacteria which continue to grow and spread. If our “last line of defense” antibiotics fail to contain these superbugs, the world could face a major pandemic that would devastate the population.
According to the Centers for Disease Control and Prevention (CDC), each year in the U.S., there are at least 2 million people who become infected with bacteria that are resistant to antibiotics. There are also at least 23,000 people who die each year as a direct result of these infections.
And according to the World Health Organization (WHO), “this serious threat is no longer a prediction for the future, it is happening right now in every region of the world and has the potential to affect anyone, of any age, in any country. Antibiotic resistance—when bacteria change so antibiotics no longer work in people who need them to treat infections—is now a major threat to public health.”
The WHO warns that without urgent, coordinated action, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill. Unless significant actions are taken to improve efforts to prevent infections and also change how we produce, prescribe and use antibiotics, the world will lose more and more of these global public health goods and the implications will be devastating.
Clearly this is a global problem that needs to be addressed immediately.
There are increasing public calls for global collective action to address the threat and these include proposals for international treaties on antimicrobial resistance. There are now also multiple national and international monitoring programs for drug-resistant threats, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant S. aureus (VRSA), extended spectrum beta-lactamase (ESBL), vancomycin-resistant Enterococcus (VRE), multidrug-resistant A. baumannii (MRAB). The promotion of better hygiene, access to clean water, infection control in health-care facilities, and vaccination–to reduce the need for antibiotics are all strategies being employed now. The WHO is also calling attention to the need to develop new diagnostics, and other tools to allow healthcare professionals to stay ahead of emerging resistance.
However, with resistance to antibiotics becoming more and more common, and because we are fast running out of effective treatment options, there is also now an urgent and greater need for the development of newer alternative treatments.
On February 27, 2017, the WHO published its first ever list of antibiotic-resistant “priority pathogens” in a bid to guide and promote research and development of new antibiotics. The list consists of a catalogue of 12 families of bacteria that pose the greatest threat to human health.
These include gram-negative bacteria that are resistant to multiple antibiotics because of their built-in abilities to find new ways to resist treatment. They pass along genetic material that allows other bacteria to become drug-resistant as well.
According to the WHO, the most critical group of all includes multidrug resistant bacteria that pose a particular threat in hospitals, nursing homes, and among patients whose care requires devices such as ventilators and blood catheters. They include Acinetobacter, Pseudomonas and various Enterobacteriaceae (including Klebsiella, E. coli, Serratia, and Proteus). They can cause severe and often deadly infections such as bloodstream infections and pneumonia.
These bacteria have become resistant to a large number of antibiotics, including carbapenems and third generation cephalosporins – the best available antibiotics for treating multidrug resistant bacteria.
Calls for new antibiotic therapies have been issued worldwide and the need is more urgent than ever. Unfortunately, new drug development has been slow and breakthroughs have been rare. Yet some researchers are now investigating whether the cannabis sativa plant may be an overlooked option to help treat this global problem.
Is cannabis – and specifically CBD – the breakthrough we’ve been waiting for?
While governments around the world are beginning to discuss ways in which to mobilize against the threat of drug-resistant bacteria, researchers have been hard at work trying to identify the next generation of drugs that will lead the fight against these rapidly evolving superbugs.
With cannabis sativa, it has been well documented that the plant contains antibacterial cannabinoids, and that they have the potential to address antibiotic resistance.
For example, in a 2008 study published in the Journal of Natural Products, a group of researchers set out to define a possible microbiocidal cannabinoid by investigating the antibacterial profile of five major cannabinoids.
The researchers found that all five major cannabinoids, cannabidiol (CBD), cannabichromene (CBC), cannabigerol (CBG), ∆9-tetrahydrocannabinol (THC), and cannabinol (CBN), showed potent activity against a variety of methicillin-resistant Staphylococcus aureus (MRSA) strains – with minimum inhibitory concentration (MIC) values in the 0.5-2 μg/mL range. In microbiology, the MIC is the lowest concentration of a chemical which prevents visible growth of a bacterium.
Given their non-psychotropic profiles, the authors found that CBD and CBG seemed especially promising. In particular, CBD showed potent antibacterial action against all of the MRSAs tested as evidenced by its group-best MIC scores. CBD scored a 1 for SA-1199B a strain that over expresses NorA (the major S. aureus multidrug transporter), 1 for RN-4220 which possesses the MsrA efflux pump, 1 for XU212 which possesses the TetK multidrug efflux pump, 0.5 for ATCC25923 which is a clinical isolate that is used as a standard laboratory testing control strain, 1 for EMRSA-15, and 1 for EMRSA-16. Epidemic methicillin-resistant Staphylococcus aureus 15 (EMRSA-15) and EMRSA-16 are pandemic MRSA strains which have received global attention due to their worldwide spread and increased prevalence. Both are primarily hospital-associated pathogens responsible for a myriad of diseases, ranging from uncomplicated skin infections to life-threatening bacteremia and pneumonia.
The authors concluded that given the availability of cannabis sativa strains producing high concentrations of non-psychotropic cannabinoids, the plant represents an interesting source of antibacterial agents to address the problem of multidrug resistance in MRSA and other pathogenic bacteria.
Although there have been no clinical trials to test the use of cannabinoids as antibacterial agents, their topical application to reduce skin colonization by MRSA seems promising. And finally, the authors pointed out that semi-purified mixtures of cannabinoids could also be used as cheap and biodegradable antibacterial agents for cosmetics and toiletries, providing an alternative to the substantially much less potent synthetic preservatives, many of which are currently questioned for their suboptimal safety and environmental profile.
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