Ibuprofen Shows Promise in Controlling S aureus

Ibuprofen succeeded in fighting S aureus in a laboratory setting, although it’s not clear whether the same effect would hold true in patients with systemic infections.

New research indicates ibuprofen can control Staphylococcus aureus in laboratory settings, although the same effect was not observed when it came to drug-resistant strains of the bacteria.

Investigators from the University of Porto in Portugal wanted to see what kind of a role repurposed products could play against S aureus, noting that the limited efficacy of existing drugs and the lengthy timeline to develop new drugs leaves clinicians with a significant therapeutic gap. The investigators sought to determine whether repurposing ibuprofen, the ubiquitous non-steroidal anti-inflammatory drug (NSAID), could play a role in filling that gap.

In search of answers, they evaluated the interaction between ibuprofen and pre-established adhered cells and 24-hour-old S aureus biofilms. The results, published in the European Journal of Medicinal Chemistry, showed the NSAID had a significant controlling effect.

“The treatment with ibuprofen promoted metabolic reductions up to 80% and total loss of culturability of adhered cells and 24 h old biofilms,” corresponding author Manuel Simoes, PhD, and colleagues wrote.

Simoes wrote that ibuprofen “demonstrated moderate efficacy to remove biofilms of S aureus CECT 976 (removal ≤ 40%), but did not display removal action against the antibiotic-resistant strains.”

The team also looked at what mechanisms were underlying the effect.

“After S aureus CECT 976 incubation with ibuprofen, cell permeation to propidium iodide, release of intracellular potassium and changes on cell surface hydrophobicity were observed,” Simoes wrote.

The team concluded that ibuprofen holds promise as a repurposed tool against S aureus.

“The overall results, demonstrate that ibuprofen can control S aureus planktonic and sessile growth, with strong destabilizing and disrupting action on the cytoplasmic membrane,” they said.

S aureus is a common hospital-acquired infection. According to the US Centers for Disease Control and Prevention (CDC), 3 in 10 people carry the bacteria in their noses without harm. Yet, when it leads to infection, S aureus can cause serious issues including pneumonia, sepsis, and heart valve issues. The CDC is currently working on a surveillance program to get a better understanding of rates of S aureus infection nationally.

Saskia Popescu, MPH, MA, CIC, an infection preventionist with Phoenix Children's Hospital and a Contagion® contributor, said that, although the results of the study are interesting, success in biofilms is not proof that a particular therapy would work in the case of a systemic infection in a real-world patient.

“I would think these results give hope that we can repurpose over the counter meds for common infections but it shouldn’t detract from stewardship efforts or R&D for new medications,” she said.

The fact that ibuprofen had less of an effect against drug resistant S aureus is a significant limitation, Popescu said, noting that these types of infections are becoming more common. Still, she said, there are plenty of cases of non-drug-resistant S aureus infection (methicillin-sensitive S aureus), so it’s worthwhile to try to find new approaches. However, she said at this point, the case for ibuprofen has a long way to go.

“I think you’d be pressed to find a provider who would give their patient ibuprofen as a treatment for MSSA,” she said.