Antibiotic combinations could slow resistance

04 September 2018

Several thousand antibiotic combinations have been found to be more effective in treating bacterial infections than first thought.
Georgina Hines

Antibiotic combination therapies are usually avoided when treating bacterial infections, with scientists believing combinations are likely to reduce the efficacy of the drugs used. Now, a group at UCLA, USA, have identified over 8,000 antibiotic combinations that work more effectively than predicted.

With eight antibiotics, an analysis was done of each four- and five-drug combination – 18,278 in total – in treating the common bacteria E. coli. Of the four-drug combinations, 1,676 performed better than expected, and of the five-drug combinations, 6,443 were deemed more effective than predicted.

‘There is a tradition of using just one drug, maybe two. We’re offering an alternative that looks very promising,’ said Pamela Yeh, Assistant Professor of Ecology and Evolutionary Biology at UCLA and a senior author of the study.

‘We shouldn’t limit ourselves to just single drugs or two-drug combinations in our medical toolbox,’ she said. ‘We expect several of these combinations or more, will work much better than existing antibiotics.’

Six of the eight antibiotics used in the study operated using a unique mechanism, perhaps contributing to the results by not blocking the actions of other drugs in the combination and adding to the total effect. But while the results are promising, the combinations have only been tested in the laboratory and are therefore not close to clinical use.

As part of the research, the group is storing the data in an open-access software called the ‘Mathematical Analysis for General Interaction of Components’ – or MAGIC for short – that will be made available next year. Other scientists will be able to view these results and add their own data that will help build the framework.

‘With the spectre of antibiotic resistance threatening to turn back health care to the pre-antibiotic era, the ability to more judiciously use combinations of existing antibiotics that singly are losing potency is welcome,’ said Michael Kurilla, Division Director of Clinical Innovation at the National Center for Advancing Translational Sciences.

‘This work will accelerate the testing in humans of promising antibiotic combinations for bacterial infections that we are ill-equipped to deal with today,’ he said.

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