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Elbaz, M., et al. Exposure to non-antimicrobial drugs and risk of urinary tract infection with drug-resistant Enterobacteriaceae. Presented at ECCMID; 9-12 July 2021 (virtual meeting).
Disclosure:
Elbaz does not report any relevant financial information.
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In a study of more than 1,800 patients in an Israeli hospital, exposure to commonly prescribed non-antimicrobial drugs was linked to an increased risk of drug-resistant infections, researchers reported at the ECCMID virtual meeting.
Three classes of drugs – proton pump inhibitors, beta blockers, and antimetabolites – have been significantly linked to resistance to antibiotics commonly used to treat urinary tract infections and other infections caused by Gram-negative bacteria, said Meital Elbaz, MD, Doctor at Tel Aviv Medical Center.
Some commonly prescribed non-antibiotic drugs could lead to antibiotic-resistant infections, researchers said.
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“Infections with drug-resistant Gram-negative bacteria have increased significantly in recent years, with infections caused by these organisms often being more common than gram-positive infections in many settings,” Elbaz told Healio. “The growing risk of antimicrobial resistance in gram-negative bacteria is a global problem due to the potential for rapid spread of resistance mechanisms and limited treatment options.”
According to Elbaz, while some commonly used non-antimicrobial drugs have been linked to changes in the gut microbiome, their role in acquiring drug-resistant bacteria has not been systematically studied.
Meital Elbaz
For their study, Elbaz and colleagues examined data from 1,807 adults who were hospitalized between January 1, 2017 and April 18, 2019 with a urinary tract infection and a positive urine or blood culture with growing Enterobacteriaceae.
According to Elbaz, they pulled records of prior use of 22 non-antimicrobial drug classes from patients’ electronic medical records prior to hospital admission.
The researchers identified antimicrobial drug-resistant organisms in more than half of the patient samples (944/1807). In almost every fourth episode (431 / 1,807) they identified multi-resistant organisms that were resistant to three or more classes of antibiotics.
Their analyzes found that the use of seven common drug categories was associated with increased resistance to antimicrobial drugs – selective serotonin reuptake inhibitors, typical antipsychotics, anticoagulants apixaban and rivaroxaban, proton pump inhibitors (PPIs), beta blockers, clopidogrel and antimetabolites.
PPIs, beta blockers, and antimetabolites were significantly associated with resistance to third generation cephalosporins, trimethoprim-sulfamethoxazole, and fluoroquinolones.
“Our results underscore the importance of exposure to non-antimicrobial drugs as a risk factor for antibiotic resistance, and previous exposure to these drugs may help clinicians choose empirical therapy in the future, although more research on larger data sets is needed,” said Elbaz.
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