NPJ Antimicrob Resist

Common OTC analgesics may fuel antibiotic resistance

September 4, 2025

Study details: This lab-based study exposed E. coli to gut-relevant concentrations of nine non-antibiotic medications (NAMs), including ibuprofen, acetaminophen, and metformin, alongside ciprofloxacin. Researchers assessed mutation frequency and resistance development.

Results: Ibuprofen and acetaminophen markedly increased mutation rates and ciprofloxacin resistance. Dual exposure amplified resistance further. Genomic analysis revealed mutations in GyrA, MarR, and AcrR, linked to efflux pump overexpression. Other NAMs also influenced resistance, though less dramatically.

Clinical impact: In polypharmacy settings—especially geriatric care—common NAMs may unintentionally promote antibiotic resistance. Clinicians should be aware of these interactions when prescribing antibiotics alongside widely used non-antibiotics.

Source:

Chen H, et al. (2025, August 25). NPJ Antimicrob Resist. The effect of commonly used non-antibiotic medications on antimicrobial resistance development in Escherichia coli. https://pubmed.ncbi.nlm.nih.gov/40855113/