REVIEW The Potential of Osteopathic Manipulative Treatment in Antimicrobial Stewardship: A Narrative Review Donald R. Noll, DO Financial Disclosures: The contemporary management of infectious diseases is built around anti None reported. microbial therapy. However, the development of antimicrobial resistance Support: None reported. threatens to create a post–antibiotic era. Antimicrobial stewardship at Address correspondence to tempts to reduce the development of antimicrobial resistance by improving Donald R. Noll, DO, their appropriate use. Osteopathic manipulative treatment as an adjunctive Professor of Medicine, Department of Geriatrics treatment has the potential for enhancing antimicrobial stewardship by en and Gerontology, hancing the human immune system, shortening the duration of antimicro New Jersey Institute bial therapy, reducing complications, and improving treatment outcomes. for Successful Aging, Rowan University School The present article reviews the evidence published in the literature since this of Osteopathic Medicine, unique treatment approach was first developed more than 100 years ago. 42 E Laurel Rd, Suite 1800, Stratford, NJ 08084-1338. The evidence suggests that adjunctive osteopathic manipulative treatment has great potential for enhancing antimicrobial stewardship and should be E-mail:
[email protected] further investigated. Submitted J Am Osteopath Assoc. 2016;116(9):600-608 January 27, 2016; doi:10.7556/jaoa.2016.119 revision received March 13, 2016; accepted April 13, 2016. here are 2 strategies for treating patients with infectious disease. The first is to target the organism with an appropriate antimicrobial agent. In 1907, Paul Ehrlich developed his “magic bullet” arsphenamine (Salvarsan) and thus began the mod- T 1 ern antibiotic era. Since then the number of safe and effective antimicrobials has greatly increased1 so that today the treatment of patients with infectious disease is built around the use of antimicrobials.2 The second strategy is to support and enhance the human immune system so that the body will heal itself.