Proton pump inhibitors, ß-blockers, and antimetabolites, commonly prescribed classes of drugs, could cause antibiotic resistance, especially in the Enterobacteriaceae family, despite the fact that they are not antibiotics.

The most common enterobacteria include Escherichia coli, Salmonella, Shigella, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter cloacae, Serratia marcescens, Proteus, Morganella and Yersinia.

A new observational study presented on 10th July at ECCMID 2021 stated these antibiotic-resistant bacterial infections could cause extended hospital stays and lead to risk of increased mortality rates.

Bacterial antibiotic resistance is often associated with over-prescription and regular exposure to antibiotics.
However, it has been noted that patients diagnosed, and admitted to the hospital, with drug-resistant bacteria show no common recognisable risk factors.

Previous studies have identified that commonly used non-antimicrobial drugs (NAMD) play a significant role in antibiotic resistance because of the consequential effect on gut microbiome bacterial composition.

The aim of this research was to address the role of NAMD use as a risk factor for infection with antibiotic-resistant bacteria.

The researchers from Tel Aviv Medical Center hospital, Israel, examined data from 1,807 patients diagnosed with upper urinary tract infection, and a positive urine or blood culture of Enterobacteriaceae, who were admitted in the hospital over a period of >2 years (from 1st January 2017 to 18th April 2019).

The researchers then acquired the electronic medical records regarding the previous and current use of 19 NAMDs.

The results showed that antimicrobial drug-resistant organisms were found in over half of the collected patient samples.

Furthermore, approximately one-quarter of samples revealed multi-drug-resistant organisms that were resistant to three or more antibiotic classes.

Interestingly, NAMDs such as selective serotonin reuptake inhibitors for depression symptoms, antipsychotics drugs for mental health, proton pump inhibitors for the reduction of stomach acid, ß-blockers for conditions associated with heart problems, and antimetabolites for the treatment of cancer and other inflammatory diseases were all linked to increased antibiotic resistance.

Additionally, antimetabolites emerged as the group of drugs with the highest influence on antibiotic resistance.

“Our findings highlight the importance of non-antimicrobial drug exposure as a risk factor for antibiotic resistance,” stated lead author Meital Elbaz, Tel Aviv Medical Center.

“We urgently need larger studies with more drug classes to confirm the discovery and to clarify the biological link between common prescription drugs and antibiotic resistance.”

Per saperne di più
Review of the 31st European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) 2021
EMJ Microbiol Infect Dis. 2021;2[1]:13-23. Congress Review.

Tel Aviv Sourasky Medical Center


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