Losing the Battle but Winning the War: Can Defeated Antibacterials Form Alliances to Combat Drug-Resistant Pathogens?
Despite the recent development of antibacterials that are active against multidrug-resistant pathogens, drug combinations are often necessary to optimize the killing of difficult-to-treat organisms. Antimicrobial combinations typically are composed of multiple agents that are active against the targ...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-05-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/10/6/646 |
| _version_ | 1797532235925028864 |
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| author | Song Oh Raymond Chau Anh T. Nguyen Justin R. Lenhard |
| author_facet | Song Oh Raymond Chau Anh T. Nguyen Justin R. Lenhard |
| author_sort | Song Oh |
| collection | DOAJ |
| description | Despite the recent development of antibacterials that are active against multidrug-resistant pathogens, drug combinations are often necessary to optimize the killing of difficult-to-treat organisms. Antimicrobial combinations typically are composed of multiple agents that are active against the target organism; however, many studies have investigated the potential utility of combinations that consist of one or more antibacterials that individually are incapable of killing the relevant pathogen. The current review summarizes in vitro, in vivo, and clinical studies that evaluate combinations that include at least one drug that is not active individually against <i>Pseudomonas aeruginosa</i>, <i>Klebsiella pneumoniae</i>, <i>Acinetobacter baumannii</i>, or <i>Staphylococcus aureus</i>. Polymyxins were often included in combinations against all three of the Gram-negative pathogens, and carbapenems were commonly incorporated into combinations against <i>K. pneumoniae</i> and <i>A. baumannii</i>. Minocycline, sulbactam, and rifampin were also frequently investigated in combinations against <i>A. baumannii</i>, whereas the addition of ceftaroline or another β-lactam to vancomycin or daptomycin showed promise against <i>S. aureus</i> with reduced susceptibility to vancomycin or daptomycin. Although additional clinical studies are needed to define the optimal combination against specific drug-resistant pathogens, the large amount of in vitro and in vivo studies available in the literature may provide some guidance on the rational design of antibacterial combinations. |
| first_indexed | 2024-03-10T10:56:13Z |
| format | Article |
| id | doaj.art-0e267148ad254ae589b16ea513be1710 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T10:56:13Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-0e267148ad254ae589b16ea513be17102023-11-21T21:50:48ZengMDPI AGAntibiotics2079-63822021-05-0110664610.3390/antibiotics10060646Losing the Battle but Winning the War: Can Defeated Antibacterials Form Alliances to Combat Drug-Resistant Pathogens?Song Oh0Raymond Chau1Anh T. Nguyen2Justin R. Lenhard3Department of Clinical and Administrative Sciences, College of Pharmacy, California Northstate University, Elk Grove, CA 95757, USADepartment of Clinical and Administrative Sciences, College of Pharmacy, California Northstate University, Elk Grove, CA 95757, USADepartment of Clinical and Administrative Sciences, College of Pharmacy, California Northstate University, Elk Grove, CA 95757, USADepartment of Clinical and Administrative Sciences, College of Pharmacy, California Northstate University, Elk Grove, CA 95757, USADespite the recent development of antibacterials that are active against multidrug-resistant pathogens, drug combinations are often necessary to optimize the killing of difficult-to-treat organisms. Antimicrobial combinations typically are composed of multiple agents that are active against the target organism; however, many studies have investigated the potential utility of combinations that consist of one or more antibacterials that individually are incapable of killing the relevant pathogen. The current review summarizes in vitro, in vivo, and clinical studies that evaluate combinations that include at least one drug that is not active individually against <i>Pseudomonas aeruginosa</i>, <i>Klebsiella pneumoniae</i>, <i>Acinetobacter baumannii</i>, or <i>Staphylococcus aureus</i>. Polymyxins were often included in combinations against all three of the Gram-negative pathogens, and carbapenems were commonly incorporated into combinations against <i>K. pneumoniae</i> and <i>A. baumannii</i>. Minocycline, sulbactam, and rifampin were also frequently investigated in combinations against <i>A. baumannii</i>, whereas the addition of ceftaroline or another β-lactam to vancomycin or daptomycin showed promise against <i>S. aureus</i> with reduced susceptibility to vancomycin or daptomycin. Although additional clinical studies are needed to define the optimal combination against specific drug-resistant pathogens, the large amount of in vitro and in vivo studies available in the literature may provide some guidance on the rational design of antibacterial combinations.https://www.mdpi.com/2079-6382/10/6/646<i>Staphylococcus aureus</i><i>Pseudomonas aeruginosa</i><i>Klebsiella pneumoniae</i>carbapenem resistance<i>Acinetobacter baumannii</i>antimicrobial combinations |
| spellingShingle | Song Oh Raymond Chau Anh T. Nguyen Justin R. Lenhard Losing the Battle but Winning the War: Can Defeated Antibacterials Form Alliances to Combat Drug-Resistant Pathogens? Antibiotics <i>Staphylococcus aureus</i> <i>Pseudomonas aeruginosa</i> <i>Klebsiella pneumoniae</i> carbapenem resistance <i>Acinetobacter baumannii</i> antimicrobial combinations |
| title | Losing the Battle but Winning the War: Can Defeated Antibacterials Form Alliances to Combat Drug-Resistant Pathogens? |
| title_full | Losing the Battle but Winning the War: Can Defeated Antibacterials Form Alliances to Combat Drug-Resistant Pathogens? |
| title_fullStr | Losing the Battle but Winning the War: Can Defeated Antibacterials Form Alliances to Combat Drug-Resistant Pathogens? |
| title_full_unstemmed | Losing the Battle but Winning the War: Can Defeated Antibacterials Form Alliances to Combat Drug-Resistant Pathogens? |
| title_short | Losing the Battle but Winning the War: Can Defeated Antibacterials Form Alliances to Combat Drug-Resistant Pathogens? |
| title_sort | losing the battle but winning the war can defeated antibacterials form alliances to combat drug resistant pathogens |
| topic | <i>Staphylococcus aureus</i> <i>Pseudomonas aeruginosa</i> <i>Klebsiella pneumoniae</i> carbapenem resistance <i>Acinetobacter baumannii</i> antimicrobial combinations |
| url | https://www.mdpi.com/2079-6382/10/6/646 |
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