Could Ancient Remedies Hold the Answer to the Looming Antibiotics Crisis?

For obvious reasons though, the plants and mushrooms with the longest histories of antibiotic use tend to be the easiest to identify. I find it generally really difficult to learn new species from field guides, but most of the stuff with antibiotic properties is pretty trivial to identify even without joining your local mycological association or native plant society.

E.g. plantago, one of the plants they are making a big deal about in the article, is almost certainly growing within a hundred yards of wherever you happen to be if you're anywhere in North America, Europe, or Asia. So yeah, while it's completely criminal that big box retailers are allowed to sell fake herbal medicines with impunity, I also think that people generally have a moral obligation to learn something about their local plants and fungi anyway.

'Proven' in this context means 'FDA-approved', but regulation in the US basically only encourages development of novel, patentable pharmaceutical compounds at the expense of everything else.

Because only novel compounds and formulations can be patented, there is zero incentive for any company to do research on plant medicinals: they wouldn't be able to recoup the cost of the research (people can just go buy the actual plant supplement, even if the company patented a different formulation).

Because only deep-pocketed pharma companies seek FDA approval for drugs, the regulatory apparatus has over time gotten more and more expensive and rigid. I believe even getting a drug to Stage 3 trials is in the tens of millions of dollars. This very high barrier to entry further forces pharmaceutical companies to only invest in drugs that will be highly profitable ('blockbusters'). (http://www.forbes.com/sites/theapothecary/2012/04/25/how-the...)

Because of the close relationship between pharmaceutical companies and doctors, it's often a large professional risk for a doctor to prescribe a supplement to a patient. If something goes wrong, the local medical board can and will go after doctors for not going with FDA approved guidelines for treatment. That's why to even see a doctor who will prescribe supplements, in the US you often have to look for a 'naturopath'.

TL;DR: regulation that favors new compounds -> no profit incentive to look at plant compounds -> no group that will lobby for change -> regulation that favors new compounds

Just as a counterpoint, herbal medicines in China are widely available, very cheap, and there is a large amount of government-funded research into which plants have what compounds and what they do. Doctors are also allowed to prescribe them and routinely do. Obviously, it helped that there was a developed system of medicine in China before Western medicine arrived.

This is somewhat similar to the status of Kampo medicine in Japan ('Kampo' literally means 'Han prescription'), except Kampo medicine isn't under as active development.

By no means is the system in China is perfect -- there's probably under-regulation of the 'patent medicine' system and a lot of low quality crap sold to the public. But at the end of the day, a large class of pharmaceutically active and relevant medicinal compounds aren't simply excluded because they don't mesh well with the basic assumptions of the regulatory apparatus.

Biological agents like phages have a much higher regulatory hurdle to clear (you need to show that they won't develop virulence), and they have also been traditionally harder to administer than drugs (e.g. phage therapy ideally requires a sample of the infectious agent and individualized identification of phage species).

Basically once we discovered penicillin, it was so cheap, effective, and easy to distribute, that we built a medical system premised on developing new drugs, and dropped most alternatives. It's very hard to turn back the clock.

FYI, one reason phage therapy continued to be developed in Eastern Europe was less widespread availability of antibiotics at the time.