Multidrug resistant (or antimicrobial-resistant) pathogens - alternatives to new antibiotics?

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State: Public
Version: author
Serval ID
serval:BIB_3D3C4EDEAE76
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Multidrug resistant (or antimicrobial-resistant) pathogens - alternatives to new antibiotics?
Journal
Swiss medical weekly
Author(s)
Brunel A.S., Guery B.
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Publication state
Published
Issued date
2017
Peer-reviewed
Oui
Volume
147
Pages
w14553
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: epublish
Abstract
For the last few decades, multidrug resistance has become an increasing concern for both Gram-positive and Gram-negative bacteria. The number of new molecules has dramatically decreased and antibiotic resistance is now a priority in the international community. Facing this new threat, a large number of new as well as "old" solutions are now being discussed in the medical community to propose an alternative to antibiotic treatments. A first option is to potentiate the effect of existing molecules through combinations to circumvent the individual molecule resistance. The second option is to neutralise either the infectious agent itself or its by-products using specific antibodies. A third option is to use the pathogen signaling mechanism and inhibit the production of virulence factor through quorum sensing inhibition. A fourth pathway would be to interact with the patient's microbiota using either probiotics or faecal transplantation to modulate the innate immune response and improve response to the infectious challenge, but also to act directly against colonisation by resistant bacteria by replacing the flora with susceptible strains. The last option is to target the bacteria using phage therapy. Phages are natural viruses that specifically infect target bacteria independently of any antibiotic-susceptibility profile. In this review, we will discuss each of these options and provide the scientific rationale and the available clinical data. In the majority of cases, these treatments represent an interesting approach but not the ultimate solution to multiresistance. Well-performed clinical trials are still missing and the major priority remains to promote good use and appropriate stewardship of antibiotics to decrease resistance.
Keywords
Anti-Infective Agents/therapeutic use, Bacteriophages, Drug Resistance, Multiple, Bacterial, Humans, Microbiota, Probiotics, Quorum Sensing
Pubmed
Web of science
Open Access
Yes
Create date
09/12/2017 11:28
Last modification date
20/08/2019 14:33
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