Are non-antibiotic drugs contributing to antimicrobial resistance?

"Guo - an environmental microbiologist at the University of Queensland in Brisbane, Australia - was studying the emergence of antibiotic-resistant bacteria in hospital waste water. His research indicated that the resistance arises in response to not just antibiotics, but also other compounds that happen to have antibacterial properties."

"His friend's daughter had epilepsy and had been prescribed the anticonvulsant drug carbamazepine. Guo thought that the girl's gastric issues might be due to the drug not only affecting her neurons, as intended, but also killing her intestinal bacteria. If so, he surmised, bacteria might evolve resistance to carbamazepine - and, more worryingly, perhaps also to antibiotics."

"The team also found that the bacteria that resisted non-antibiotic drugs most strongly were also the most resistant to antibiotics. "That basically implies that if you develop a resistance to a non-antibiotic drug, that will result in a cross-resistance to an antibiotic," Maier says."

""Bacteria don't care if we call a drug an antibiotic or not; they only care whether it has an antibacterial activity," says Ronen Ben-Ami, an infectious-disease physician at Tel Aviv Sourasky Medical Centre in Israel."

An environmental microbiologist studied antibiotic-resistant bacteria in hospital wastewater and found resistance can arise from compounds with antibacterial properties beyond antibiotics. A case involving a child taking carbamazepine for epilepsy led to the hypothesis that the drug could kill intestinal bacteria and drive evolution of resistance to carbamazepine and potentially antibiotics. In 2019, carbamazepine was shown to induce resistance to several commonly used antibiotics in cultured bacteria. A 2018 study tested nearly 1,200 drugs against intestinal bacteria and found 24% had antibacterial activity. Bacteria most resistant to non-antibiotic drugs were also most resistant to antibiotics, indicating cross-resistance. Bacteria respond to antibacterial activity regardless of drug classification.

Read at Nature