The antibiotic resistance crisis, with a focus on the United States

Martens, Evan; Demain, Arnold L.

doi:10.1038/ja.2017.30

Cited by 368 publications

(295 citation statements)

References 71 publications

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“…The emerging crisis that is pan antibiotic resistance, compounded by a dearth of new antibiotics in the development pipeline [12] is necessitating new approaches to chemotherapy to minimize resistance emergence and dissemination. Many clinical treatment strategies have been proposed, ranging from combinatorial therapy to antibiotic cycling incorporation in the treatment of everyday infections in order to mitigate resistance emergence.…”

Section: Discussionmentioning

confidence: 99%

Pharmacodynamic Considerations of Collateral Sensitivity in Design of Antibiotic Treatment Regimen

Udekwu

Weiss

2017

Preprint

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Antibiotics have greatly reduced the morbidity and mortality due to infectious diseases. Although antibiotic resistance is not a new problem, its breadth now constitutes a significant threat to human health. One strategy to help combat resistance is to find novel ways to use existing drugs, even those that display high rates of resistance. For the pathogens Escherichia coli and Pseudomonas aeruginosa, pairs of antibiotics have been identified for which evolution of resistance to drug A increases sensitivity to drug B and visa versa. These research groups have proposed cycling such pairs to treat infections, similar treatment strategies are being investigated for various cancer forms as well.While an exciting treatment prospect, no cycling experiments have yet been performed with consideration of pharmacokinetics (PK) and pharmacodynamics (PD). To test the plausibility of this scheme and search for ways to optimize it, we create a mathematical model with explicit PK-PD considerations. We study several possible treatment protocols using pairs of such antibiotics, and investigate the speed of ascent of multiply resistant mutants. Our analyses show that for low concentrations of antibiotics, treatment failure will always occur due to the rapid ascent and fixation of resistant mutants. However, at moderate to high concentrations of some types of bacteriostatic antibiotics with multiday cycling, resistance is prevented from developing and treatment succeeds. This calls for guarded optimism of such treatment protocols whose development can be directed by these types of models.

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Section: Discussionmentioning

confidence: 99%

Pharmacodynamic Considerations of Collateral Sensitivity in Design of Antibiotic Treatment Regimen

Udekwu

Weiss

2017

Preprint

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“…Sin embargo, actualmente existe un problema a nivel mundial dado por la resistencia progresiva de las bacterias a los antibióticos más frecuentemente utilizados, determinando así la necesidad de una constante búsqueda y descubrimiento de nuevos antibióticos para el tratamiento de estas cepas 1 . La resistencia a antimicrobianos constituye un problema objetivo y real en la atención de salud, a nivel mundial y local 2 .…”

Section: Introductionunclassified

Análisis de susceptibilidad antimicrobiana y hallazgos microbiológicos: perfil en cirugía abdominal de urgencia

et al. 2018

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Microbiological findings and antimicrobial susceptibility analysis: emergency general abdominal surgery profileBackground: Antimicrobial resistance is a worldwide problem. In patients requiring emergency surgery, antibiotics are an important assistance additional to surgical intervention. Objective: Analize peritoneal fluid cultures obtaines from patients who underwent emergency surgery. Methods: A prospective cohort of emergency abdominal surgical patients were enrolled. Peritoneal fluid cultures were taken and processed according to standarized technique. Results: A 39.4% of positive cultures was found. E. coli was the most common bacteria identified. Five positive cultures for P. aeruginosa stand out. E. coli had 25% resistance to ampicillin/sulbactam and 19% for quinolones. Conclusion: Resistance found was lower than international reports, but still noteworthy. Knowledge of local bacteria profile and antimicrobial resistance is important for local antibiotic hospital policy. Key words: Peritoneal fluid; Emergency surgery; Antibiogram. ResumenIntroducción: La resistencia a antibióticos es un problema mundial. En los pacientes que requieren cirugía de urgencia, los antibióticos son un apoyo importante concomitante al acto quirúrgico. Objetivo: Analizar los cultivos de líquido peritoneal obtenidos de pacientes operados por patología quirúrgica abdominal de urgencia. Materiales y Métodos: Se realiza una cohorte prospectiva de los pacientes operados de urgencia. Se tomó cultivo de líquido peritoneal y se procesó según técnica estandarizada. Resultados: Se encontró un 39,4% de cultivos positivos. E. coli fue el germen más frecuente. Destacan 5 cultivos positivos para P. aeruginosa. Existe un 25% de resistencia a ampicilina/sulbactam y 19% a quinolonas para E. coli. Conclusión: La resistencia encontrada fue menor a lo reportado en la literatura, pero aún destacable. El conocimiento del perfil de bacterias y sus resistencias a antimicrobianos son importantes para las políticas hospitalarias locales de uso racional de antibióticos.

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“…One of the most significant problems faced by the world in recent years is the appearance of antibiotic resistance and the adaptation of microorganisms to conventional therapies as a result of improper use [1,2].…”

Section: Introductionmentioning

confidence: 99%

Collagen-Nanoparticles Composites for Wound Healing and Infection Control

Grigore

Grumezescu

Holban

et al. 2017

Metals

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Nowadays, the world is facing a serious crisis represented by the rapid emergence of resistant bacteria, which jeopardizes the efficacy of antibiotics. This crisis has been attributed to the overuse and misuse of antibiotics, as well as the cessation of new drug production by the pharmaceutical industry. Therefore, bacterial strains with resistance to multiple antibiotic classes have appeared, such as Staphylococcus aureus, Acinetobacter spp. and Pseudomonas aeruginosa. This review aims to provide an updated summary of the current approach to the treatment of infections due to resistant microorganisms, with a focus on the application of the antimicrobial effects of inorganic nanoparticles in combination with collagen to promote wound healing. In addition, the paper describes the current approaches in the field of functionalized collagen hydrogels capable of wound healing and inhibiting microbial biofilm production.

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The antibiotic resistance crisis, with a focus on the United States

Cited by 368 publications

References 71 publications

Pharmacodynamic Considerations of Collateral Sensitivity in Design of Antibiotic Treatment Regimen

Pharmacodynamic Considerations of Collateral Sensitivity in Design of Antibiotic Treatment Regimen

Análisis de susceptibilidad antimicrobiana y hallazgos microbiológicos: perfil en cirugía abdominal de urgencia

Collagen-Nanoparticles Composites for Wound Healing and Infection Control

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