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Over-the-counter antibiotics compromising aminoglycoside activity.

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Over-the-counter antibiotics like gramicidin can reduce the effectiveness of essential clinical antibiotics by damaging bacterial membranes. This interference contributes to antimicrobial resistance (AMR) and potential treatment failures.

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Area of Science:

  • Microbiology
  • Pharmacology
  • Infectious Diseases

Background:

  • Antimicrobial resistance (AMR) is a critical global health challenge.
  • Over-the-counter (OTC) antibiotics, particularly in sore throat remedies, may contribute to AMR.
  • Concerns exist that OTC antibiotics could induce cross-resistance to clinically important antibiotics.

Purpose of the Study:

  • To investigate the in vitro impact of three antibiotics found in OTC sore throat medications on emerging AMR.
  • To determine if OTC antibiotics affect the efficacy of commonly used clinical antibiotics.

Main Methods:

  • Bacterial pathogens were subjected to time-kill assays with aminoglycoside antibiotics, alone and with OTC antibiotics (bacitracin, gramicidin, tyrothricin).
  • Membrane damage was assessed by measuring potassium leakage and membrane potential alterations after OTC antibiotic exposure.

Main Results:

  • Gramicidin significantly reduced the bactericidal activity of amikacin, tobramycin, and gentamicin against Acinetobacter baumannii.
  • Gramicidin and tyrothricin diminished aminoglycoside efficacy in other key pathogens like Enterobacter cloacae, Escherichia coli, and Klebsiella pneumoniae.
  • Gramicidin exposure led to significant bacterial membrane potential decrease and potassium leakage.

Conclusions:

  • Gramicidin and tyrothricin interfere with aminoglycoside efficacy by disrupting bacterial membrane potential, crucial for drug uptake.
  • These findings highlight a potential mechanism by which OTC antibiotics can lead to treatment failure and contribute to AMR development.
  • While concurrent use may be uncommon, this study underscores a possible pathway for OTC antibiotic contribution to resistance and treatment efficacy issues.