Researchers, in a new study, have reported that widely used painkillers, ibuprofen and paracetamol, are fuelling one of the world’s biggest health threats: antibiotic resistance.
They suggested that older people were most at risk because they are more likely to be prescribed multiple medications, not just antibiotics, but also drugs for pain, sleep, or blood pressure, making it an ideal breeding ground for resistant bacteria to thrive in their gut.
In the first study of its kind, researchers found that ibuprofen and paracetamol not only help bacteria outsmart antibiotics but also make infections harder to treat when used together.
The team at the University of South Australia looked at the interaction of non-antibiotic medications, the broad-spectrum antibiotic ciprofloxacin, and Escherichia coli (E. coli) — a common bacterium that causes gut and urinary tract infections. Ciprofloxacin is commonly used to treat common skin, gut, or urinary tract infections.
The findings, published in the journal npj Antimicrobials and Resistance, showed that ibuprofen and paracetamol significantly increased bacterial mutations, making E. coli highly resistant to the antibiotic.
The study assessed nine medications commonly used in residential aged care: ibuprofen (an anti-inflammatory pain relief), diclofenac (an anti-inflammatory to treat arthritis), acetaminophen (paracetamol for pain and fever), furosemide (for high blood pressure), metformin (for high sugar levels linked to diabetes), atorvastatin (to help lower cholesterol and fats in the blood), tramadol (a stronger pain medication post-surgery), temazepam (used to treat sleeping problems), and pseudoephedrine (a decongestant).
The World Health Organisation reports that antimicrobial resistance is a global threat to public health and that bacterial resistance was directly responsible for 1.27 million global deaths in 2019.
Lead researcher and an associate professor at the varsity, Rietie Venter, declared that antibiotic resistance isn’t just about antibiotics anymore.
Venter said, “When bacteria were exposed to ciprofloxacin alongside ibuprofen and paracetamol, they developed more genetic mutations than with the antibiotic alone, helping them grow faster and become highly resistant.
“Worryingly, the bacteria were not only resistant to the antibiotic ciprofloxacin, but increased resistance was also observed to multiple other antibiotics from different classes.”
This study is a clear reminder that we need to carefully consider the risks of using multiple medications, particularly in aged care, where residents are often prescribed a mix of long-term treatments.
While this doesn’t mean “we should stop using these medications, but we do need to be more mindful about how they interact with antibiotics and that includes looking beyond just two-drug combinations,” Venter said.
The researchers are calling for further studies into drug interactions among anyone on long-term medication treatment regimens, so we can gain a greater awareness of how common medications may impact antibiotic effectiveness.
