Exposure to Non-Antimicrobial Drugs and Risk of Infection with Antibiotic-Resistant Enterobacteriaceae

Antimicrobial resistance (AMR) has consistently been linked to antibiotic use. However, the roles of commonly prescribed non-antimicrobial drugs as drivers of AMR may be under-appreciated. Here, we studied a cohort of patients with community-acquired pyelonephritis and assessed the association of ex...

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Bibliographic Details
Published in:Antibiotics (Basel) 2023-04, Vol.12 (4), p.789
Main Authors: Elbaz, Meital, Stein, Esther, Raykhshtat, Eli, Weiss-Meilik, Ahuva, Cohen, Regev, Ben-Ami, Ronen
Format: Article
Language:English
Subjects:
Anti-inflammatory agents
Antibiotic resistance
Antibiotics
Anticoagulants
Antimetabolites
Antimicrobial agents
Antimicrobial resistance
Bacteria
Beta blockers
Bivariate analysis
Catheters
Clopidogrel
Cytotoxicity
Drug resistance
Drug resistance in microorganisms
Drugs
E coli
Exposure
Genotype & phenotype
Health aspects
Health risks
Hospital costs
Infection
Inhibitors
Intubation
Medical research
Medicine, Experimental
modeling
Mortality
Multidrug resistant organisms
non-antimicrobial drugs
Nosocomial infections
Patients
Phenotypes
Pyelonephritis
Resistance factors
Risk factors
Serotonin
Serotonin uptake inhibitors
Ticagrelor
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Summary:Antimicrobial resistance (AMR) has consistently been linked to antibiotic use. However, the roles of commonly prescribed non-antimicrobial drugs as drivers of AMR may be under-appreciated. Here, we studied a cohort of patients with community-acquired pyelonephritis and assessed the association of exposure to non-antimicrobial drugs at the time of hospital admission with infection with drug-resistant organisms (DRO). Associations identified on bivariate analyses were tested using a treatment effects estimator that models both outcome and treatment probability. Exposure to proton-pump inhibitors, beta-blockers, and antimetabolites was significantly associated with multiple resistance phenotypes. Clopidogrel, selective serotonin reuptake inhibitors, and anti-Xa agents were associated with single-drug resistance phenotypes. Antibiotic exposure and indwelling urinary catheters were covariates associated with AMR. Exposure to non-antimicrobial drugs significantly increased the probability of AMR in patients with no other risk factors for resistance. Non-antimicrobial drugs may affect the risk of infection with DRO through multiple mechanisms. If corroborated using additional datasets, these findings offer novel directions for predicting and mitigating AMR.
ISSN:2079-6382
2079-6382
DOI:10.3390/antibiotics12040789