Nikhil Prasad Fact checked by:Thailand Medical News Team Aug 21, 2026 1 hour, 2 minutes ago
Antibiotics have saved countless lives, but a major scientific review is raising a less familiar safety question: could some of these widely used medicines also cause damage to DNA and other genetic material in human cells?
A scientific review suggests some antibiotic classes may damage DNA through several biological pathways, although real-world human risks remain uncertain
The review examined evidence involving major antibiotic groups, including fluoroquinolones, nitroimidazoles, aminoglycosides, macrolides, beta-lactams, and tetracyclines. The researchers' institutions were Çanakkale Onsekiz Mart University, Sakarya University, and Ataturk University in Türkiye.
Three Routes to Genetic Damage
The review identified three main biological pathways through which antibiotics may place stress on genetic material.
Fluoroquinolone antibiotics can interfere with enzymes called topoisomerases, which normally help DNA unwind and reorganize safely. Experimental evidence suggests this interference can contribute to DNA double-strand breaks.
A second pathway involves mitochondria, the structures that produce much of a cell's energy. Because mitochondria retain similarities to bacteria, antibiotics designed to attack bacterial machinery can sometimes interfere with mitochondrial functions. This may increase reactive oxygen species, unstable molecules capable of damaging DNA.
The third pathway involves inflammation and oxidative stress, sometimes influenced by antibiotic-related disruption of the gut microbiome.
Different Antibiotics, Different Levels of Concern
Importantly, the evidence does not suggest that every antibiotic carries the same potential risk. Fluoroquinolones showed strong mechanistic evidence for DNA-related effects, while aminoglycosides had particularly convincing links between mitochondrial damage and toxicity in kidney and inner-ear tissues.
Nitroimidazoles, including metronidazole, can form DNA-damaging compounds under certain biological conditions. However, laboratory evidence of genotoxicity has not consistently translated into clear long-term cancer risks in people.
Beta-lactams, including commonly prescribed drugs such as amoxicillin, appeared to have relatively little direct genotoxic activity. Their potential effects may instead occur indirectly through changes in intestinal bacteria and subsequent oxidative stress.
This
Thailand Medical News report also highlights tetracyclines, where prolonged exposure may interfere with mitochondrial function and eventually increase oxidative DNA damage, although the long-term consequences in humans remain uncertain.
Human Risk Remains Unclear
One of the review's most important warnings concerns interpretation. Much of the positive evidence comes from laboratory cells or animal research, sometimes involving antibiotic concentrations considerably higher than normal blood levels in patients.
Ch
ildren, pregnant women, older adults, and cancer patients could theoretically be more vulnerable because of differences in metabolism, DNA repair, antioxidant defenses, medication exposure, or rapidly dividing cells. However, direct human evidence remains limited, particularly for children and pregnancy.
Conclusions
The findings do not mean people should avoid medically necessary antibiotics. Instead, the review suggests DNA safety deserves greater attention alongside antibiotic resistance, especially when drugs are repeatedly or unnecessarily prescribed. Larger human studies using realistic doses are needed to determine whether laboratory evidence translates into meaningful long-term health risks and which patients may be most susceptible.
The study findings were published in the peer reviewed International Journal of Molecular Sciences.
https://www.mdpi.com/1422-0067/27/16/7460
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