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After a nearly threefold drop in prescriptions for the antibiotic ciprofloxacin between 2015 and 2021, the rates of ciprofloxacin-resistant E. coli bacteria circulating in the community did not decline. In fact, a study of Seattle-area women over age 50 who had not taken any antibiotics for at least a year discovered that the incidence of gut-colonizing ciprofloxacin-resistant E. coli actually increased. About 1 in 5 women in the study were affected. The results are consistent with theoretical models indicating that, once a drug-resistant form of E.coli emerges, it will continue to spread by taking up long-term residence in individuals’ gut microbiomes. Antibiotic resistant E. coli in the gut is of concern because the bacteria can enter the urinary tract and cause difficult-to-treat infections, particularly in women. Evidence from studies such as this one may be changing paradigms on how to fight the rise in antibiotic resistance.

United statesVeronical tchesnokovaJames ralstonEvgeniv sokurenkoInfectious disease society of americaKaiser permanente washington health research instituteDrug administrationUniversity of washington school medicineNational institutes of healthUw school of medicineCommunications medicineMethod of researchNational institute for allergyCenters for diseaseWashington schoolSeattle children