Oxidation and Unconventional Approaches to Infection including ozone therapy

Background

Antibiotic-resistant bacteria, biofilm-forming pathogens and hard-to-treat viral infections have become a growing problem in modern medicine. Before antibiotics existed, clinicians used a different family of tools: therapies that work by generating controlled, short-lived reactive oxygen species (ROS) in the body. This chapter, written for a major medical reference work, revisits that older approach and asks whether oxidation-based therapies still have a role to play alongside, or instead of, antimicrobial drugs.

Study design

This is not a clinical trial. It is a narrative chapter in Elsevier's Encyclopedia of Infection and Immunity, written by physician Robert Jay Rowen. The chapter draws together published literature, historical accounts and clinical experience covering five ROS-generating approaches: ozone therapy, ultraviolet blood irradiation (UBI), intravenous high-dose ascorbate (vitamin C), hydrogen peroxide therapy, and hyperbaric oxygen therapy (HBOT). Rather than testing one intervention in one patient group, it summarises the existing evidence base and reasoning behind each therapy's proposed antimicrobial and immune-modulating effects.

Findings

The chapter's central argument is that generating ROS in a controlled way can help the immune system fight infection, including infections caused by organisms that no longer respond well to standard antibiotics. Each of the five therapies discussed - ozone therapy, UBI, intravenous ascorbate, hydrogen peroxide and HBOT - is presented as working through a broadly similar mechanism: mild, transient oxidative stress that stimulates immune cell activity and antioxidant defences, rather than simply poisoning the pathogen directly as antibiotics do. The author notes that reported side effects across these approaches are uncommon when used appropriately, though he is clear this needs to be kept in mind by anyone considering them.

What the authors concluded

Rowen concludes that these oxidation-based approaches are worth further exploration and clinical use, either as alternatives to antimicrobial drugs or used alongside them, particularly given the rising burden of drug-resistant infection. He frames them as a historically established but currently under-used option that deserves more attention from mainstream medicine and further research investment.

Limitations of this study

As a narrative encyclopedia chapter rather than a systematic review or clinical trial, this work does not independently generate new data, apply a standardised search or grading method, or quantify effect sizes. It reflects one author's synthesis and clinical viewpoint, drawing on a mix of historical reports, mechanistic reasoning and case-level clinical experience rather than large controlled trials. The quality and quantity of evidence differs considerably between the five therapies it covers, and the chapter itself does not claim to resolve this. Readers should treat it as a starting point for further reading rather than definitive proof of clinical efficacy for any single therapy, and any decision to use these approaches for a specific infection should involve a qualified healthcare practitioner.