Drug combinations alter the effectiveness of antibiotics



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July 4, 2018

The effectiveness of antibiotics can be modified by combining them with each other, non-antibiotic drugs or even with food additives. Depending on the bacterial species, certain combinations prevent antibiotics from functioning to their full potential while others begin to overcome antibiotic resistance, report EMBL researchers and collaborators in Nature 4th of July

. Scientists have described nearly 3,000 drug combinations on three different pathogenic bacteria. The research was conducted by EMBL group leader Nbados Typas.

Overcoming Antibiotic Resistance

The overuse and abuse of antibiotics has led to widespread antibiotic resistance. Specific combinations of drugs can help fight multidrug-resistant bacterial infections, but they are largely unexplored and rarely used in clinics. This is why in this article, the team has systematically studied the effect of matched antibiotics with each other, as well as other drugs and food additives in different species.

While many of the drug combinations studied decreased the effect of antibiotics, there were more than 500 drug combinations that improved the antibiotic outcome. A selection of these positive matches was also tested in multidrug-resistant bacteria isolated from infected hospital patients and improving antibiotic effects.

Clinical vanillin?

When vanillin – the compound that gives vanilla its distinctive taste – was badociated with a particular antibiotic known as spectinomycin, it helped the antibiotic to enter bacterial cells and to inhibit their growth. Spectinomycin was originally developed in the early 1960s for the treatment of gonorrhea, but is rarely used today because of the bacterial resistance developed against it. However, in combination with vanillin, it may become clinically relevant again and used for other pathogens. "Among the tested combinations, it's one of the most effective and promising synergies we've identified," says Ana Rita Brochado, first author on the journal and research scientist at EMBL. . Pairings like this could extend the arsenal of weapons to the war against antibiotic resistance.

Curiously, however, vanillin mitigates the effect of many other types of antibiotics. The paper showed that vanillin works in the same way as aspirin to decrease the activity of many antibiotics – although its effects on human cells have not been tested, they are probably different .

According to Nbados Typas, the effect of antibiotics could also be beneficial for human health. "Antibiotics can cause collateral damage and side effects because they also target healthy bacteria, but the effects of these drug combinations are very selective and often affect only a few bacterial species. the harmful effects of antibiotics on healthy bacteria, which would also reduce the development of antibiotic resistance, as healthy bacteria would not be under pressure to develop antibiotic resistance, which could then be transmitted to dangerous bacteria.

This research is the first large-scale screening of drug combinations between different bacterial species in the laboratory. The compounds used have already been approved for safe use in humans, but studies in mice and clinical studies are still needed to test the efficacy of particular drug combinations in humans. In addition to identifying new drug combinations, the size of this study has allowed scientists to understand some of the general principles that underlie drug interactions. This will allow for a more rational selection of drug pairs in the future and could be broadly applicable to other therapeutic areas.

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