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Painkillers May Fuel Antibiotic Resistance, Study Finds

Common painkillers like ibuprofen and acetaminophen may fuel antibiotic resistance, raising urgent questions about drug interactions in aged care and beyond.

Ibuprofen and acetaminophen (paracetamol) are among the most widely used pain and fever remedies, but new findings from the University of South Australia suggest they may be contributing to a global health crisis: antibiotic resistance.

In a pioneering study, scientists discovered that each drug, on its own, can encourage bacteria to become resistant to antibiotics, and when taken together, they appear to intensify this effect.

By examining how these medicines interact with E. coli – a bacterium often responsible for gut and urinary tract infections – the team observed that ibuprofen and acetaminophen accelerated genetic changes, making the bacteria more resistant not only to ciprofloxacin but also to other types of antibiotics.

This raises meaningful concerns for vulnerable groups,especially older adults in residential care facilities where multiple medications are commonly prescribed.The findings highlight the need for greater caution around everyday drug use and its potential role in worsening antibiotic resistance.

The World Health Organization (WHO) 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, Associate Professor Rietie venter says the findings raise important questions about the risks of polypharmacy in aged care.

“Antibiotics have long been vital in treating infectious diseases, but their widespread overuse and misuse have driven a global rise in antibiotic-resistant bacteria,” Assoc Prof Venter says. “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.”

The study looked at the effect of non-antibiotic medicines and 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 ciprofloxacin, but increased resistance was also observed to multiple other antibiotics from different classes.

“We also uncovered the genetic mechanisms behind this resistance, with ibuprofen and paracetamol both activating the bacteria’s defenses 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 (for arthritis), acetaminophen (for pain and fever), furosemide (for high blood pressure), metformin (related to diabetes), atorvastatin (to lower cholesterol), tramadol (stronger pain medication post-surgery), temazepam (for sleeping problems), and pseudoephedrine (a decongestant).

Assoc prof Venter says the study shows that antibiotic resistance is a more complex challenge than previously understood.

“It’s not just about antibiotics anymore,” she says. “We need to consider the potential for interactions between different medications, especially in aged care where multiple medications are commonly prescribed.”

What specific formulation challenges exist with ibuprofen syrups and how do they relate to ensuring accurate dosage?

Global Health Threat: how Common Painkillers like Ibuprofen May Be Linked to Escalating Health Risks

The Ubiquitous Painkiller: Ibuprofen and Its Forms

Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), is a household name globally. Available in numerous forms – tablets,capsules,granules,intravenous solutions,syrups,suppositories,creams,and powders – its accessibility contributes to widespread use. However, this very accessibility masks potential health risks that are becoming increasingly apparent.Notably,liquid formulations,like ibuprofen syrups,frequently enough exist as suspensions due to the drug’s poor water solubility,requiring vigorous shaking before each dose to ensure accurate medication delivery. This seemingly minor detail highlights a broader issue: even proper use doesn’t guarantee complete safety.

Cardiovascular Concerns: A Growing Body of Evidence

For years, concerns have been mounting regarding the link between prolonged NSAID use, including ibuprofen, and increased cardiovascular risk.

Increased Risk of Heart Attack & Stroke: Studies demonstrate a statistically critically important elevation in the risk of myocardial infarction (heart attack) and stroke, even within the first few weeks of using NSAIDs.The risk appears dose-dependent, meaning higher doses correlate with greater risk.

Blood Pressure Elevation: Ibuprofen can lead to hypertension or exacerbate existing high blood pressure. This is notably perilous for individuals already at risk for cardiovascular disease.

Heart Failure: Prolonged use can contribute to fluid retention, potentially leading to or worsening heart failure.

Atrial Fibrillation: Emerging research suggests a possible link between NSAID use and an increased incidence of atrial fibrillation, an irregular heartbeat that can increase stroke risk.

These risks aren’t limited to individuals with pre-existing heart conditions. Even those with healthy hearts can be vulnerable.

Gastrointestinal Distress: A Well-known,Yet Persistent Problem

while cardiovascular risks are gaining prominence,the gastrointestinal (GI) side effects of ibuprofen remain a significant concern.

Stomach Ulcers & Bleeding: Ibuprofen inhibits the production of prostaglandins, which protect the stomach lining. This can lead to the formation of ulcers and, in severe cases, gastrointestinal bleeding.

Dyspepsia (Indigestion): Common symptoms include heartburn, bloating, and abdominal pain.

Increased Risk with Concurrent Medications: Combining ibuprofen with other medications like aspirin or anticoagulants considerably increases the risk of GI bleeding.

Silent Ulcers: Some individuals may experience no symptoms until a serious complication, such as bleeding, occurs.

Kidney Function & Ibuprofen: A Delicate Balance

The kidneys play a crucial role in filtering waste products from the blood.Ibuprofen can interfere with this process,potentially leading to kidney damage.

Acute Kidney Injury (AKI): Ibuprofen can reduce blood flow to the kidneys, increasing the risk of AKI, especially in individuals who are dehydrated, have pre-existing kidney disease, or are taking other nephrotoxic medications.

Chronic Kidney Disease (CKD) Progression: Long-term ibuprofen use can accelerate the progression of CKD.

Fluid Retention & Electrolyte Imbalance: Ibuprofen can cause the kidneys to retain sodium and water, leading to edema (swelling) and electrolyte imbalances.

Premature Closure of Ductus Arteriosus: In the fetus, ibuprofen can cause premature closure of the ductus arteriosus, a blood vessel essential for fetal circulation.

Oligohydramnios: Reduced amniotic fluid levels, which can impair fetal lung progress.

Increased Risk of Miscarriage: some studies suggest a possible association between early pregnancy ibuprofen use and an increased risk of miscarriage.

Beyond Common Side Effects: Emerging Concerns

Research continues to uncover potential links between ibuprofen and other health issues.

Male Infertility: some studies suggest that prolonged ibuprofen use may negatively impact male fertility by affecting testosterone production.

Asthma Exacerbation: Ibuprofen can trigger asthma attacks in susceptible individuals.

Drug Interactions: Ibuprofen interacts with numerous medications, potentially altering their effectiveness or increasing the risk of side effects. (e.g., blood thinners, certain blood pressure medications).

Lowest Effective Dose: Use the lowest dose of ibuprofen necessary to manage your pain.

Shortest Duration: Limit the duration of use to the shortest time possible.

Hydration: Drink plenty of fluids while taking ibuprofen to protect your kidneys.

Avoid Combining with Other NSAIDs: Do not take ibuprofen with other NSAIDs, such as naproxen or aspirin.

Consider Alternatives: Explore non-pharmacological pain management techniques