| Peer-reviewed | Experimental study | Animals |
Giving mice a drug that protects gut bacteria alongside intravenous antibiotics reduces the growth of antibiotic-resistant bacteria in the intestines, suggests a study published today in eLife.
Treatment with antibiotics can inadvertently lead to bacteria becoming resistant to the drugs. This has resulted in a growing number of bacterial infections that are difficult or impossible to treat. The current study, originally posted on bioRxiv*, suggests a strategy that might prevent antibiotic treatment from creating drug-resistant bacteria.
“Hospitals are often a source of antibiotic-resistant bacteria, because patients with serious infections are often treated with antibiotics,” explains first author Valerie Morley, Postdoctoral Scholar at the Center for Infectious Disease Dynamics, Pennsylvania State University (Penn State), US. “This treatment often unintentionally kills many of the bacteria that normally live in the intestines while leaving behind those that survive the antibiotics. These antibiotic-resistant bacteria may then spread among patients in the hospital.”
Morley and colleagues investigated a potential method to prevent this resistance in mice. They tested whether administering an oral cholesterol-lowering drug called cholestyramine during treatment with the intravenous antibiotic daptomycin could prevent the enrichment of antibiotic-resistant bacteria (Enterococcus faecium) in the microbiome.
“If cholestyramine inactivates daptomycin in the intestines, this strategy could allow antibiotic treatment of infections in the bloodstream, while removing selection for drug-resistant gut microbes,” Morley says. “This would help reduce the transmission of antibiotic-resistant bacteria in hospitals.”
When the team treated mice with intravenous daptomycin and oral cholestyramine at the same time, they found fewer antibiotic-resistant bacteria in the intestines than in mice treated with daptomycin alone. Their findings provide proof-of-concept for a new approach to reduce the spread of antibiotic resistance by protecting the microbiome from antibiotics.
The authors suggest this strategy could eventually be translated into human patients and reduce the spread of antibiotic-resistant bacteria: hospital patients receiving antibiotic treatment could also receive an ‘anti-antibiotic,’ which would inactivate the antibiotic in the intestines and protect the gut microbiome.
“However, the strategy needs to be optimised before moving it into human patients,” adds senior author Andrew Read, Director of the Huck Institutes for the Life Sciences at Penn State. “For example, we need better data on daptomycin concentrations in the human intestine, how they vary over time, and how much they vary between individuals. But if it ultimately proves to be successful in humans, this strategy could allow physicians to treat many types of infections with antibiotics while reducing the risk of antibiotic resistance.”
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Reference
*This study was originally posted on the preprint server bioRxiv, at https://www.biorxiv.org/content/10.1101/2020.04.24.059444v2.
It will be published as part of Evolutionary Medicine: A Special Issue from eLife. For more information, see https://elifesciences.org/inside-elife/bb34a238/special-issue-call-for-papers-in-evolutionary-medicine.
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