Some categories of widely used formulations seem to make us more vulnerable to antibiotic-resistant infections.
A double-edged sword proves to be some commonly used medications, as it seems that on the one hand they can relieve the body from the symptoms of chronic diseases, but on the other hand they make the immune system weaker against infections, increasing the body’s resistance to antibiotics.
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More specifically, according to new research data presented at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID), there are three categories of prescription drugs that are not included in antibiotics: proton pump inhibitors (PPIs), beta-blockers and anti-metabolites.
These classes of drugs could lead to antibiotic-resistant infections caused by Enterobacteriaceae bacteria such as E. coli.
These antibiotic-resistant infections are in turn associated with increased hospitalization time and possibly a higher risk of death.
These are widely used drugs that are administered to treat and alleviate the symptoms of chronic diseases, but also cause significant side effects, which are not always visible to patients.
For example, some non-antibiotic drugs have been shown to disrupt the function of the intestinal microbiome. However, their role as a risk factor for infections by antibiotic-resistant bacteria had not been established.
The researchers looked at data from 1,807 adults admitted to a university hospital in Tel Aviv, Israel between January 1, 2017 and April 18, 2019. Patients were admitted to the hospital with upper urinary tract infection, with positive results in urine culture or blood tests. The use of 19 non-antibiotic treatments prior to hospitalization was confirmed by the patients’ medical history.
Antibiotic-resistant organisms were detected in almost half of the patients (944/1,807), while organisms resistant to several other treatments (in 3 or more classes of antibiotics) were detected in about a quarter of cases (431 / 1,807).
Further analysis showed that the use of the following common classes of drugs was associated with increased resistance to antibiotics:
- SSRIs (selective serotonin reuptake inhibitors),
- antipsychotics for the treatment of schizophrenia,
- anticoagulants to prevent stroke in patients with atrial fibrillation,
- proton pump inhibitors (PPIs) that reduce the production of stomach acids,
- beta-blockers that help treat heart disease and
- Anti-metabolites (chemotherapeutic agents) commonly used to treat certain types of cancer and inflammatory diseases.
The researchers also found that three classes of drugs (PPIs, beta-blockers and antimetabolites) were most directly associated with resistance to third-generation cephalosporins, trimethoprim-sulfamethoxazole and fluoroquinolones, active ingredients of several antibiotics.
Anti-metabolites appear to have the strongest impact on antibiotic resistance.
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However, the researchers point to the limitations of the study on the small sample of patients regarding the use of certain drugs, as well as the lack of information on the dosage and duration of taking non-antibiotic drugs.
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