2023/09/28 by Elisabetta Cacace, Vladislav Kim, Vallo Varik +17 · 1 voice · 2 citations
Biochemistry, Genetics and Molecular Biology · Immunology and Microbiology · #Antibiotic Resistance in Bacteria #Antibiotic Use and Resistance #Biochemical and Structural Characterization
paper · pdf · doi:10.1038/s41564-023-01486-9
openalex publication_date 2023/09/28 · openalex created_date 2023/09/29 · openalex updated_date 2026/08/01
Drug combinations can expand options for antibacterial therapies but have not been systematically tested in Gram-positive species. We profiled ~8,000 combinations of 65 antibacterial drugs against the model species Bacillus subtilis and two prominent pathogens, Staphylococcus aureus and Streptococcus pneumoniae. Thereby, we recapitulated previously known drug interactions, but also identified ten times more novel interactions in the pathogen S. aureus, including 150 synergies. We showed that two synergies were equally effective against multidrug-resistant S. aureus clinical isolates in vitro and in vivo. Interactions were largely species-specific and synergies were distinct from those of Gram-negative species, owing to cell surface and drug uptake differences. We also tested 2,728 combinations of 44 commonly prescribed non-antibiotic drugs with 62 drugs with antibacterial activity against S. aureus and identified numerous antagonisms that might compromise the efficacy of antimicrobial therapies. We identified even more synergies and showed that the anti-aggregant ticagrelor synergized with cationic antibiotics by modifying the surface charge of S. aureus. All data can be browsed in an interactive interface ( https://apps.embl.de/combact/ ).