Over-the-counter painkillers may make C.difficile more aggressive

Over-the-counter painkillers such as aspirin and ibuprofen may make the deadly superbug C.difficile more aggressive

  • Just 20% of mice treated with the painkiller indomethacin survived C.difficile
  • Compared to 80% of the rodents not treated but infected with the bacteria
  • Painkillers inhibit an enzyme that produces hormones linked to gut health 

Over-the-counter painkillers like aspirin and ibuprofen may make the potentially deadly superbug C.difficile more aggressive, research suggests.

Just a fifth of mice treated with the non-steroidal anti-inflammatory drug (NSAID) indomethacin survived being exposed to the infection.

In contrast, 80 per cent of the rodents not given the painkiller survived, scientists discovered.

Indomethacin also caused the animals to have more severe tissue damage in their intestines and a greater disturbance to their gut bacteria make-up.

The NSAID inhibits the enzyme cyclooxygenase, which then disrupts the production of prostaglandins. 

These hormones are released at sites of injury to aid healing and are critical to maintaining gut health. 

Painkillers like aspirin may make the deadly superbug C.difficile more aggressive (stock)

The research was carried out by Vanderbilt University, and led by the microbiologist and infectious diseases expert Professor David Aronoff. 

C.difficle is the most common hospital-acquired infection in the US and an ‘urgent public health threat worldwide,’ the authors wrote in the journal mBio. 

The bacterial infection kills nearly 30,000 people each year in the US alone. Of those who survive, the infection reoccurs between 20 and 30 per cent of the time.

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NSAIDs are among the most commonly-prescribed drugs in the US, with more than 98million prescriptions being filed each year, while around 29million Americans take over-the-counter versions of the medication. 

Side effects can range from mild diarrhoea to deadly expansion of the colon and even death, particularly in the elderly. 

NSAIDs have previously been associated with an increased risk of catching C.difficile, as well as a more severe infection. 


NHS disinfection guidelines may be inadequate because they do not kill diarrhoea-causing bugs, research suggested in October.

C.difficile spores purposely placed onto bed sheets survived the technique used throughout NHS hospitals, a study by De Montfort University found.

Tests showed industrial-strength bleach and high washing machine temperatures of 75°C for at least three minutes only killed 35 per cent of the spores.

These sheets are often rented out by companies between multiple hospitals and care homes, which may explain why patients can be struck by infections without any obvious source.

The NHS sets a standard of no dangerous bacteria remaining on contaminated sheets after they have been washed.

To better understand this, the researchers treated mice with indomethacin for two days. 

The rodents were then given the antibiotic cefoperazone as a preventative treatment before being infected with C.difficile. 

This brief indomethacin exposure dramatically increased the animals’ death rate from 20 per cent to 80 per cent. 

The mice exposed to indomethacin also experienced more severe tissue damage to their cecums – the pouch that connects the small and large intestine – than the untreated rodents.

The indomethacin-treated animals also had greater amounts of gut bacteria in their livers, which suggests the NSAID disrupted their intestinal barriers, causing bugs to leave their guts and enter other parts of their bodies. 

Injury to the intestinal barrier can also lead to the release of inflammatory molecules that cause the colon to swell, leading to diarrhoea and vomiting.    

The researchers believe their study highlights the importance of taking NSAIDs with care if there is a heightened risk of catching C.difficile. 

‘We are always trying to think of modifiable risk factors for the disease,’ Professor Aronoff said. 

‘Ultimately, these new results might guide how we treat people with C.diff, particularly with pain management.

‘Right now, it’s too early for our results to guide clinical care, but they should be a stimulus for future studies.’

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