title: Antimicrobial Effects of Antipyretics.
abstract: Antipyretics are some of the most commonly used drugs. Since they are often coadministered with antimicrobial therapy, it is important to understand the interactions between these two classes of drugs. Our review is the first to summarize the antimicrobial effects of antipyretic drugs and the underlying mechanisms involved. Antipyretics can inhibit virus replication, inhibit or promote bacterial or fungal growth, alter the expression of virulence factors, change the surface hydrophobicity of microbes, influence biofilm production, affect the motility, adherence, and metabolism of pathogens, interact with the transport and release of antibiotics by leukocytes, modify the susceptibility of bacteria to antibiotics, and induce or reduce the frequency of mutations leading to antimicrobial resistance. While antipyretics may compromise the efficacy of antimicrobial therapy, they can also be beneficial, for example, in the management of biofilm-associated infections, in reducing virulence factors, in therapy of resistant pathogens, and in inducing synergistic effects. In an era where it is becoming increasingly difficult to find new antimicrobial drugs, targeting virulence factors, enhancing the efficacy of antimicrobial therapy, and reducing resistance may be important strategies.
authors.affiliation: Department of Paediatrics, The University of Melbourne, Parkville, Australia petra.zimmermann@rch.org.au.|Infectious Diseases & Microbiology Research Group, Murdoch Children's Research Institute, Parkville, Australia.|Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia.
authors.forename: Petra
authors.initials: P
authors.lastname: Zimmermann
authors.affiliation: Department of Paediatrics, The University of Melbourne, Parkville, Australia.|Infectious Diseases & Microbiology Research Group, Murdoch Children's Research Institute, Parkville, Australia.|Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia.
authors.forename: Nigel
authors.initials: N
authors.lastname: Curtis
mesh_terms: D000818:Animals; D000890:Anti-Infective Agents / Q000378:metabolism / Q000494:pharmacology*; D058633:Antipyretics / Q000378:metabolism / Q000494:pharmacology*; D018441:Biofilms / Q000187:drug effects; D001692:Biological Transport / Q000187:drug effects; D003141:Communicable Diseases / Q000188:drug therapy* / Q000382:microbiology / Q000469:parasitology / Q000821:virology; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005334:Fever / Q000188:drug therapy* / Q000382:microbiology / Q000469:parasitology / Q000821:virology; D006801:Humans; D057927:Hydrophobic and Hydrophilic Interactions; D009154:Mutation / Q000187:drug effects; D037521:Virulence Factors / Q000819:agonists / Q000037:antagonists & inhibitors / Q000096:biosynthesis; D014779:Virus Replication / Q000187:drug effects
chemical_list: D000890:Anti-Infective Agents; D058633:Antipyretics; D037521:Virulence Factors
keywords: NSAIDs; acetaminophen; antibacterial; antimicrobial; efflux pumps; ibuprofen; paracetamol