Antibiotic resistance is a global health threat. Sub-inhibitory antibiotic concentrations have been linked to antibiotic resistance dissemination through horizontal gene transfer. This study investigates the role of non-antibiotic pharmaceuticals in spreading antibiotic resistance. Commonly used drugs, including NSAIDs (ibuprofen, naproxen, diclofenac), gemfibrozil, and propranolol, accelerated plasmid-borne bacterial conjugation at clinically and environmentally relevant concentrations. Increased membrane and whole-genome permeability correlated with enhanced conjugation. These drugs induced responses similar to antibiotic exposure, including SOS response activation and efflux pump enhancement. The findings highlight the potential of non-antibiotic pharmaceuticals to enhance the spread of antibiotic resistance.

Yue Wang, Ji Lu, Shuai Zhang, Jie Li, Likai Mao, Zhiguo Yuan, Philip L. Bond, Jianhua Guo