• Dr Emma Derbyshire

Can Vitamins Help Antibiotics Combat Superbugs: A Potential Synergistic Antimicrobial Effect


What is Antibiotic Resistance?

Antibiotic resistance is when bacteria develops the ability to resist the effects of antibiotics that could once successfully treat that bacteria. Antibiotic resistance is a subset of antimicrobial resistance, which is when a microorganism including bacteria, viruses, fungi and parasites develops the ability to resist the effects of medication that could once successfully treat the microorganism.


What are Superbugs?

Microorganisms that develop antimicrobial resistance to antibiotics, antivirals, antifungals, antimalarials or anthelmintics can be termed ‘superbugs’. This includes bacterial infections that are resistant to the treatment of antibiotics. As a result of the superbug, medications once successful in their treatment become ineffective and the infection persists resulting in an increased risk of spreading the superbug to others.


Multidrug-resistant superbugs, including Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus (MRSA), are a challenge for medical professionals and it is reported that nearly one million people die every year from bacterial infections that cannot be treated with common antibiotics. What makes this all the more serious is that as of today, we do not have any other alternative to antibiotics in the treatment of bacterial infections.


Acinetobacter baumannii

A. baumannii is a Gram-negative bacillus which appears to exhibit extensive resistance to most first-line antibiotics. It is an opportunistic bacterial pathogen mainly associated with hospital-acquired infections and also combat troops returning from conflict zones.


Methicillin-resistant Staphylococcus aureus

Staphylococcus aureus is a Gram-positive coccus which is a major pathogen both within hospitals and in the community. Methicillin is a β-lactam antibiotic most often prescribed to treat S. aureus. Methicillin-resistant S. aureus isolates are often resistant to other classes of antibiotics making treatment options restricted.


Why do Multidrug Resistant Superbugs Develop?

Unfortunately, it is the way we have been using antibiotics that has helped to create the development of new drug-resistant superbugs.


Antibiotics are one of the most commonly prescribed drugs, and they are also administered to livestock to prevent disease and also to enhance the animals’ growth. However, many antibiotics prescribed to both people and animals are not necessary and it is this overuse and misuse of antibiotics that is helping to create drug-resistant bacteria.


When antibiotics are overused and misused bacteria that are able to survive the drug will replicate and grow quickly resulting in this drug-resistant strain of the bacteria spreading and thriving. Antibiotics are thus becoming less effective and will eventually stop working completely against certain disease-causing bacteria.


Can Vitamins Help Antibiotics?

A study recently published in the Synergyy aimed to investigate the potential synergistic activity of vitamins with antibiotics against resistant bacterial strains. The synergistic effects between antibiotics and stock solutions of vitamins were evaluated. The vitamins studied in combination with the antibiotics were vitamin B1 (thiamine), B2 (riboflavin), B6 (pyridoxine), B12 (methylcobalamin), C (ascorbic acid), A (retinol), D (cholecalciferol), E (α-tocopherol) and K (menadione).


The results demonstrated that vitamins K and E had good synergistic activity with piperacillin/tazobactam, imipenem and doripenem against A. baumannii, whilst vitamins B1, B2 and B12 showed remarkable synergistic activity with linezolid against MRSA. Vitamin B1 was further shown to have better synergism with oxacillin, tetracycline, rifampicin and linezolid against MRSA. The fat-soluble vitamins E and K showed good synergism against Gram-negative A. baumannii, whilst the water-soluble vitamins B1, B2 and B12 were effective against MRSA but not against A. baumannii.

  1. Vitamins E and K showed effective synergistic activity against Acinetobacter baumannii.

  2. Vitamin B2 showed most effective synergistic activity against MRSA.

  3. Vitamin K showed remarkable synergistic activity against A. baumannii but next to no synergism against MRSA.

Conclusions

This study has shown that antibiotic therapy against highly resistant bacteria may be successful if the antibiotics are used in combination with vitamins. As such, this synergistic action of vitamins with antibiotics may be used as a tool to treat multidrug-resistant superbugs. Further research is required at a molecular level and to investigate the mechanism of interaction of vitamins with antibiotics and with bacteria.


References

Shahzad S. et al. (2018) Evaluation of synergistic antimicrobial effect of vitamins (A, B1, B2, B6, B12, C, D, E and K) with antibiotics against resistant bacterial strains. J Glob Antimicrob Resist. Jun;13:231-236

#Antibioticresistance #Synergy #Vitamins

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