American Journal of Infectious Diseases and Microbiology
ISSN (Print): 2328-4056 ISSN (Online): 2328-4064 Website: Editor-in-chief: Maysaa El Sayed Zaki
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American Journal of Infectious Diseases and Microbiology. 2017, 5(1), 66-73
DOI: 10.12691/ajidm-5-1-4
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Antibacterial Activity of Some Non-steroidal Anti-inflammatory Drugs against Bacteria Causing Urinary Tract Infection

Eman Farouk Ahmed1, , Rehab Mahmoud Abd El-Baky2, Abo Bakr F Ahmed2, 3, Nancy Gamil Waly2 and Gamal Fadl Mahmoud Gad2

1Department of Microbiology and Immunology, Faculty of Pharmacy, Deraya University, Minia, Egypt

2Department of Microbiology and Immunology, Faculty of Pharmacy, Minia University

3Department of Microbiology and Immunology, Faculty of Pharmacy, Hail University, KSA

Pub. Date: March 10, 2017

Cite this paper:
Eman Farouk Ahmed, Rehab Mahmoud Abd El-Baky, Abo Bakr F Ahmed, Nancy Gamil Waly and Gamal Fadl Mahmoud Gad. Antibacterial Activity of Some Non-steroidal Anti-inflammatory Drugs against Bacteria Causing Urinary Tract Infection. American Journal of Infectious Diseases and Microbiology. 2017; 5(1):66-73. doi: 10.12691/ajidm-5-1-4


This study aims to evaluate the effect of NSAIDs on the activity of some antibiotics against urinary tract pathogens. Urine samples were collected and cultured on cysteine lactose electrolyte deficient (CLED) media and MICs for some antibiotics and NSAIDs were determined using Agar dilution method. The combined effects of some NSAIDs and some β-lactam antibiotics were tested on standard strains by checkerboard dilution technique. Out of 100 samples (63 female patients and 37 male patients suffering from UTIs), 122 bacterial strains were isolated. E. coli and Coagulase negative Staphylococci (CoNS) were the most common (39.3% and 26.2%, respectively), followed by S. aureus (9.8%), Klebsiella spp, Enterococcus faecalis (7.4% each), P. aeruginosa (3.2%), Streptococci, Proteus spp. (2.5% each) and Bacillus spp. (1.6%). Most strains showed high resistance against the tested antibiotics. Diclofenac sodium and indomethacin showed the lowest MIC90 against the tested strains. All the tested NSAIDs significantly lowered the MICs of antibiotics against the tested bacteria and FICIs for these combinations ranged from 0.004 to 0.5. In conclusion, NSAIDs significantly increased the therapeutic activity of the tested antibiotics showing good synergistic effect.

UTI NSAIDs antibacterial resistance synergism

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[1]  Stamm WE. Scientific and clinical challenges in the management of urinary tract infections. The American journal of medicine. 2002; 113: 1-4.
[2]  Weinstein MP, Towns ML, Quartey SM, Mirrett S, Reimer LG, Parmigiani G, et al. The clinical significance of positive blood cultures in the 1990s: a prospective comprehensive evaluation of the microbiology, epidemiology, and outcome of bacteremia and fungemia in adults. Clinical Infectious Diseases. 1997; 24: 584-602.
[3]  Sheerin NS. Urinary tract infection. Medicine. 2015; 43: 435-9.
[4]  Stamm WE, Norrby SR. Urinary tract infections: disease panorama and challenges. Journal of infectious diseases. 2001; 183: S1-S4.
[5]  Organization WH. World Health Organization report on infectious diseases 2000: overcoming antimicrobial resistance. January 2001. 2005.
[6]  Resolution EC. A strategy against the microbial threat. Official Journal C. 1999; 195: 1-3.
[7]  Gupta K, Bhadelia N. Management of urinary tract infections from multidrug-resistant organisms. Infectious disease clinics of North America. 2014; 28: 49-59.
[8]  Chattopadhyay, Dastidar, Chakrabarty. Anti-microbial property of methdilazine and its synergism with antibiotics and some chemotherapeutic agents. Arzneim Forsch. 1988; 38: 869-72.
[9]  Roy K, Chakrabarty A. Anti-bacterial activities of anti-histamine triprolidine hydrochloride (actidil) and cross-resistances to antibiotics developed by experimentally derived mutants resistant to this drug. Indian J Med Microbiol. 1994; 12: 9-18.
[10]  Dastidar S, Jairaj J, Mookerjee M, Chakrabarty A. Studies on antimicrobial effect of the antihistaminic phenothiazine trimeprazine tartrate. Acta microbiologica et immunologica Hungarica. 1996; 44: 241-7.
[11]  Molnar J, Mandi Y, Kiraly J. Antibacterial effect of some phenothiazine compounds and R-factor elimination by chlorpromazine. Acta microbiologica Academiae Scientiarum Hungaricae. 1975; 23: 45-54.
[12]  Kristiansen JE. Experiments to illustrate the effect of chlorpromazine on the permeability of the bacterial cell wall. Acta Pathol Microbiol Scand B. 1979; 87: 317-9.
[13]  Kristiansen JE, Mortensen I. Antibacterial effect of four phenothiazines. Pharmacol Toxicol. 1987; 60: 100-3.
[14]  Nakka M, Nallapati SB, Reddy LV, Murakkant K, Pal.S. Synthesischaracterization and anti-bacterial screening of piroxicam based sulfonates. JChemPharmRes. 2011; 3: 581-8.
[15]  Annadurai S, Basu S, Ray S, Dastidar S, Chakrabarty A. Antibacterial activity of the antiinflammatory agent diclofenac sodium. Indian journal of experimental biology. 1998; 36: 86-90.
[16]  Kristiansen JE. The antimicrobial activity of non-antibiotics. Report from a congress on the antimicrobial effect of drugs other than antibiotics on bacteria, viruses, protozoa, and other organisms. APMIS Suppl. 1992; 30: 7-14.
[17]  Winn WC, Koneman EW. Koneman's color atlas and textbook of diagnostic microbiology: Lippincott williams & wilkins; 2006.
[18]  Rusu E, Sarbu I, Pelinescu D, Nedelcu I, Vassu T, Cristescu C, et al. INFLUENCE OF ASSOCIATING NONSTEROIDAL ANTI-INFLAMMATORY DRUGS WITH ANTIFUNGAL COMPOUNDS ON VIABILITY OF SOME CANDIDA STRAINS. Romanian Journal of Infectious Diseases. 2014; 17.
[19]  Nobmann P, Bourke P, Dunne J, Henehan G. In vitro antimicrobial activity and mechanism of action of novel carbohydrate fatty acid derivatives against Staphylococcus aureus and MRSA. Journal of applied microbiology. 2010; 108: 2152-61.
[20]  Ahmed EF, El-Baky RMA, Ahmed ABF, Fawzy NG, Aziz NA, Gad GFM. Evaluation of antibacterial activity of some non-steroidal anti-inflammatory drugs against Escherichia coli causing urinary tract infection. African Journal of Microbiology Research. 2016; 10: 1408-16.
[21]  Lorian V. Antibiotics in laboratory medicine: Lippincott Williams & Wilkins; 2005.
[22]  Kiffer CR, Mendes C, Oplustil CP, Sampaio JL. Antibiotic resistance and trend of urinary pathogens in general outpatients from a major urban city. International braz j urol. 2007; 33: 42-9.
[23]  Ghonemy TA, Farag SE, Soliman SA, El-okely A, El-hendy Y. Epidemiology and risk factors of chronic kidney disease in the El-Sharkia Governorate, Egypt. Saudi Journal of Kidney Diseases and Transplantation. 2016; 27: 111.
[24]  Das R, Chandrashekhar T, Joshi H, Gurung M, Shrestha N, Shivananda P. Frequency and susceptibility profile of pathogens causing urinary tract infections at a tertiary care hospital in western Nepal. Singapore medical journal. 2006; 47: 281.
[25]  Akhter T, BAQAI R, Aziz M. Antibacterial effect of NSAIDS on clinical isolates of urinary tract infection and diabetic foot infection. Pakistan journal of pharmaceutical sciences. 2010; 23.
[26]  Agpaoa VV, Mendoza JB, Fernandez AJM, Veloso JD, Bhatnagar S. Predict Urinary Tract Infection and to Estimate Causative Bacterial Class in a Philippine Subspecialty Hospital. Journal of Nephrology & Therapeutics. 2015.
[27]  Mubanga P, Steinberg WJ, Van Rooyen FC. Antimicrobial susceptibility profile of uropathogens in Maluti Adventist Hospital patients, 2011. African journal of primary health care & family medicine. 2015; 7: 1-5.
[28]  Mazumdar K, Dutta NK, Dastidar SG, Motohashi N, Shirataki Y. Diclofenac in the management of E. coli urinary tract infections. In vivo. 2006; 20: 613-9.
[29]  Salem-Milani A, Balaei-Gajan E, Rahimi S, Moosavi Z, Abdollahi A, Zakeri-Milani P, et al. Antibacterial effect of diclofenac sodium on Enterococcus faecalis. Journal of dentistry (Tehran, Iran). 2013; 10: 16.
[30]  Muller E, Al-Attar J, Wolff AG, Farber BF. Mechanism of salicylate-mediated inhibition of biofilm in Staphylococcus epidermidis. Journal of Infectious Diseases. 1998; 177: 501-3.
[31]  Polonio RE, Mermel LA, Paquette GE, Sperry JF. Eradication of biofilm-forming Staphylococcus epidermidis (RP62A) by a combination of sodium salicylate and vancomycin. Antimicrobial agents and chemotherapy. 2001; 45: 3262-6.
[32]  Al‐Bakri A, Othman G, Bustanji Y. The assessment of the antibacterial and antifungal activities of aspirin, EDTA and aspirin–EDTA combination and their effectiveness as antibiofilm agents. Journal of applied microbiology. 2009; 107: 280-6.
[33]  Aumercier M, Murray D, Rosner J. Potentiation of susceptibility to aminoglycosides by salicylate in Escherichia coli. Antimicrobial agents and chemotherapy. 1990; 34: 786-91.
[34]  Obad J, Šušković J, Kos B. Antimicrobial activity of ibuprofen: new perspectives on an “Old” non-antibiotic drug. European Journal of Pharmaceutical Sciences. 2015; 71: 93-8.
[35]  Al-Janabi AA. In vitro antibacterial activity of Ibuprofen and acetaminophen. J Glob Infect Dis. 2010; 2: 105-8.
[36]  Vik I, Bollestad M, Grude N, Bærheim A, Mölstad S, Bjerrum L, et al. Ibuprofen versus mecillinam for uncomplicated cystitis-a randomized controlled trial study protocol. BMC infectious diseases. 2014; 14: 1.
[37]  Annadurai S, Guha-Thakurta A, Sa B, Ray SDR, Chakrabarty A. Experimental studies on synergism between aminoglycosides and the antimicrobial antiinflammatory agent diclofenac sodium. Journal of chemotherapy. 2002; 14: 47-53.
[38]  Dutta NK, Mazumdar K, Dastidar SG, JH. P. Activity of diclofenac used alone and in combination with streptomycin against Mycobacterium tuberculosis in mice. Int J Anti-microb Agents. 2007; 30: 336-40.
[39]  Dastidar SG, Annadurai S, Kumar KA, Dutta N, Chakrabarty A. Evaluation of a synergistic combination between the non-antibiotic microbicides diclofenac and trifluoperazine. International journal of antimicrobial agents. 2003; 21: 599-601.
[40]  Rosner JL. Nonheritable resistance to chloramphenicol and other antibiotics induced by salicylates and other chemotactic repellents in Escherichia coli K-12. Proceedings of the National Academy of Sciences. 1985; 82: 8771-4.
[41]  Del Prado G, Martínez-Marín C, Huelves L, Gracia M, Rodríguez-Cerrato V, Fernández-Roblas R, et al. Impact of ibuprofen therapy in the outcome of experimental pneumococcal acute otitis media treated with amoxicillin or erythromycin. Pediatric research. 2006; 60: 555-9.
[42]  Dutta NK, Annadurai S, Mazumdar K, Dastidar SG, Kristiansen JE, Molnar J, et al. Potential management of resistant microbial infections with a novel non-antibiotic: the anti-inflammatory drug diclofenac sodium. International journal of antimicrobial agents. 2007; 30: 242-9.
[43]  Dutta N, Mazumdar K, Park JH. In vitro synergistic effect of gentamicin with the anti‐inflammatory agent diclofenac against Listeria monocytogenes. Letters in applied microbiology. 2009; 48: 783-5.