Targeted treatment for bacterial infections: prospects for pathogen-specific antibiotics coupled with rapid diagnostics

Abstract

Antibiotics are a cornerstone of modern medicine and have significantly reduced the burden of infectious diseases. However, commonly used broad-spectrum antibiotics can cause major collateral damage to the human microbiome, causing complications ranging from antibiotic-associated colitis to the rapid spread of resistance. Employing narrower spectrum antibiotics targeting specific pathogens may alleviate this predicament as well as provide additional tools to expand an antibiotic repertoire threatened by the inevitability of resistance. Improvements in clinical diagnosis will be required to effectively utilize pathogen-specific antibiotics and new molecular diagnostics are poised to fulfill this need. Here we review recent trends and the future prospects of deploying narrower spectrum antibiotics coupled with rapid diagnostics. Further, we discuss the theoretical advantages and limitations of this emerging approach to controlling bacterial infectious diseases.

Antimicrobial and Antibiofilm Activity of Human Milk Oligosaccharides against Streptococcus agalactiae, Staphylococcus aureus, and Acinetobacter baumannii

“…In terms of antibiotic development, narrow-spectrum antibiotics are highly valuable and advantageous over broad-spectrum antibiotics due to their lower susceptibility to resistance development, decreased collateral damage to the host microbiome, and decreased development of antibiotic-associated colitis. 53 To compliment these advantages, HMOs are themselves nontoxic at any concentration and are well-known to aid in proper neonate microbiome development. As such, we feel that HMOs possessing narrow-spectrum antibacterial activity represent particularly exciting tools to combat infectious disease.…”

High-Definition Medicine

“…There is an urgent need for the development of novel high precision antibiotics, however the commercial development and clinical application of narrow spectrum antibiotics is challenging, in part due to the delay between onset of an infection and identification of the bacterial strain via traditional diagnostic approaches. The advent of rapid molecular diagnostics for infectious disease will remove this hurdle, improving the feasibility of the commercial development and clinical application of narrow spectrum antibiotics, as well as combatting the emergence of antibiotic resistance (Maxson and Mitchell, 2016). Rapid molecular diagnostics can generally identify also elucidate the antibiotic resistance profile of pathogens, making antibiotic treatments more effective.…”

Narrow-spectrum antibacterial agents

“…This test provides results in approximately 15 min at the point-of-care, as compared to up to two days for culture based identification and has a specificity of greater than 95% and a sensitivity of greater than or equal to 90%. 36, 37 Rapid antigen testing is limited in scope and is currently only available for a small number of select pathogens, but possibilities for extension to additional pathogens exist, particularly for indications in which clinical signs pint to a specific type of infection. 37 …”

“…36, 37 Rapid antigen testing is limited in scope and is currently only available for a small number of select pathogens, but possibilities for extension to additional pathogens exist, particularly for indications in which clinical signs pint to a specific type of infection. 37 …”