Common painkillers may boost antibiotic resistance when combined: Study
NEW DELHI: Ibuprofen and paracetamol are among the most common over-the-counter medications people take when they feel unwell. But a new study has shown that taking these medicines could be quietly fuelling one of the world’s biggest health threats: antibiotic resistance.
In the first study of its kind, published in the journal npj Antimicrobials and Resistance, researchers found that ibuprofen and paracetamol not only drive antibiotic resistance when used individually but amplify it when used together.
According to the World Health Organization (WHO), antimicrobial resistance is a global threat to public health, with bacterial resistance directly responsible for 1.27 million deaths worldwide in 2019.
Researchers assessed 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. They found that ibuprofen and paracetamol significantly increased bacterial mutations, making E. coli highly resistant to the antibiotic.
Researchers from the University of South Australia said this is an important finding with serious health implications, particularly for people in aged care homes where multiple medications are regularly administered.
“Antibiotics have long been vital in treating infectious diseases, but their widespread overuse and misuse have driven a global rise in antibiotic-resistant bacteria,” said Associate Prof Rietie Venter, lead researcher and associate professor of clinical and health sciences at the University of South Australia.
“This is especially prevalent in residential aged care facilities, where older people 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 gut bacteria to become resistant to antibiotics,” she added.
The lead researcher said that in the study, they examined the effect of non-antibiotic medicines combined with ciprofloxacin, an antibiotic used to treat common skin, gut, or urinary tract infections.
“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,” she added.
“We also identified the genetic mechanisms behind this resistance, with ibuprofen and paracetamol both activating the bacteria’s defences to expel antibiotics and render them less effective.”
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 study showed that antibiotic resistance is a more complex challenge than previously understood, with common non-antibiotic medications also playing a role.
“Antibiotic resistance isn’t just about antibiotics anymore,” Associate Prof Venter said, adding that the 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.
“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,” she added.