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Chapter 12 Antimicrobial Therapy Antibiotics
Chapter 12 Antimicrobial Therapy Topics: • Ideal drug - Antimicrobial Therapy - Selective Toxicity • Terminology - Survey of Antimicrobial Drug • Antibiotics - Microbial Drug Resistance - Drug and Host Interaction An ideal antimicrobic: Chemotherapy is the use of any chemical - soluble in body fluids, agent in the treatment of disease. - selectively toxic , - nonallergenic, A chemotherapeutic agent or drug is any - reasonable half life (maintained at a chemical agent used in medical practice. constant therapeutic concentration) An antibiotic agent is usually considered to - unlikely to elicit resistance, be a chemical substance made by a - has a long shelf life, microorganism that can inhibit the growth or - reasonably priced. kill microorganisms. There is no ideal antimicrobic An antimicrobic or antimicrobial agent is Selective Toxicity - Drugs that specifically target a chemical substance similar to an microbial processes, and not the human host’s. antibiotic, but may be synthetic. Antibiotics Spectrum of antibiotics and targets • Naturally occurring antimicrobials – Metabolic products of bacteria and fungi – Reduce competition for nutrients and space • Bacteria – Streptomyces, Bacillus, • Molds – Penicillium, Cephalosporium * * 1 The mechanism of action for different 5 General Mechanisms of Action for antimicrobial drug targets in bacterial cells Antibiotics - Inhibition of Cell Wall Synthesis - Disruption of Cell Membrane Function - Inhibition of Protein Synthesis - Inhibition of Nucleic Acid Synthesis - Anti-metabolic activity Antibiotics -
Antibiotic Resistance: from the Bench to Patients
antibiotics Editorial Antibiotic Resistance: From the Bench to Patients Márió Gajdács 1,* and Fernando Albericio 2,3 1 Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, Dóm tér 10., 6720 Szeged, Hungary 2 School of Chemistry, University of KwaZulu-Natal, Durban 4001, South Africa 3 Department of Organic Chemistry, University of Barcelona, CIBER-BBN, 08028 Barcelona, Spain * Correspondence: [email protected]; Tel.: +36-62-341-330 Received: 20 August 2019; Accepted: 26 August 2019; Published: 27 August 2019 The discovery and subsequent clinical introduction of antibiotics is one of the most important game-changers in the history of medicine [1]. These drugs have saved millions of lives from infections that would previously have been fatal, and later, they allowed for the introduction of surgical interventions, organ transplantation, care of premature infants, and cancer chemotherapy [2]. Nevertheless, the therapy of bacterial infections is becoming less and less straightforward due to the emergence of multidrug resistance (MDR) in these pathogens [3]. Direct consequences of antibiotic resistance include delays in the onset of the appropriate (effective) antimicrobial therapy, the need to use older, more toxic antibiotics (e.g., colistin) with a disadvantageous side-effect profile, longer hospital stays, and an increasing burden on the healthcare infrastructure; overall, a decrease in the quality-of-life (QoL) and an increase in the mortality rate of the affected patients [4,5]. To highlight the severity of the issue, several international declarations have been published to call governments around the globe to take action on antimicrobial resistance [6–9]. Since the 1980s, pharmaceutical companies have slowly turned away from antimicrobial research and towards the drug therapy of chronic non-communicable diseases [10,11]. -
Antimicrobial Resistance Benchmark 2020 Antimicrobial Resistance Benchmark 2020
First independent framework for assessing pharmaceutical company action Antimicrobial Resistance Benchmark 2020 Antimicrobial Resistance Benchmark 2020 ACKNOWLEDGEMENTS The Access to Medicine Foundation would like to thank the following people and organisations for their contributions to this report.1 FUNDERS The Antimicrobial Resistance Benchmark research programme is made possible with financial support from UK AID and the Dutch Ministry of Health, Welfare and Sport. Expert Review Committee Research Team Reviewers Hans Hogerzeil - Chair Gabrielle Breugelmans Christine Årdal Gregory Frank Fatema Rafiqi Karen Gallant Nina Grundmann Adrián Alonso Ruiz Hans Hogerzeil Magdalena Kettis Ruth Baron Hitesh Hurkchand Joakim Larsson Dulce Calçada Joakim Larsson Marc Mendelson Moska Hellamand Marc Mendelson Margareth Ndomondo-Sigonda Kevin Outterson Katarina Nedog Sarah Paulin (Observer) Editorial Team Andrew Singer Anna Massey Deirdre Cogan ACCESS TO MEDICINE FOUNDATION Rachel Jones The Access to Medicine Foundation is an independent Emma Ross non-profit organisation based in the Netherlands. It aims to advance access to medicine in low- and middle-income Additional contributors countries by stimulating and guiding the pharmaceutical Thomas Collin-Lefebvre industry to play a greater role in improving access to Alex Kong medicine. Nestor Papanikolaou Address Contact Naritaweg 227-A For more information about this publication, please contact 1043 CB, Amsterdam Jayasree K. Iyer, Executive Director The Netherlands [email protected] +31 (0) 20 215 35 35 www.amrbenchmark.org 1 This acknowledgement is not intended to imply that the individuals and institutions referred to above endorse About the cover: Young woman from the Antimicrobial Resistance Benchmark methodology, Brazil, where 40%-60% of infections are analyses or results. -
The Antimicrobial Agent Fusidic Acid Inhibits Organic Anion Transporting Polypeptide–Mediated Hepatic Clearance and May Potentiate Statin-Induced Myopathy
1521-009X/44/5/692–699$25.00 http://dx.doi.org/10.1124/dmd.115.067447 DRUG METABOLISM AND DISPOSITION Drug Metab Dispos 44:692–699, May 2016 Copyright ª 2016 by The American Society for Pharmacology and Experimental Therapeutics The Antimicrobial Agent Fusidic Acid Inhibits Organic Anion Transporting Polypeptide–Mediated Hepatic Clearance and May Potentiate Statin-Induced Myopathy Heather Eng, Renato J. Scialis, Charles J. Rotter, Jian Lin, Sarah Lazzaro, Manthena V. Varma, Li Di, Bo Feng, Michael West, and Amit S. Kalgutkar Pharmacokinetics, Pharmacodynamics, and Metabolism Department–New Chemical Entities, Pfizer Inc., Groton, Connecticut (H.E., R.J.S., C.J.R., J.L., S.L., M.V.V., L.D., B.F., M.W.); and Pharmacokinetics, Pharmacodynamics, and Metabolism Department–New Chemical Entities, Pfizer Inc., Cambridge MA (A.S.K.) Received September 28, 2015; accepted February 12, 2016 Downloaded from ABSTRACT Chronic treatment of methicillin-resistant Staphylococcus aureus with an IC50 value of 157 6 1.0 mM and was devoid of breast strains with the bacteriostatic agent fusidic acid (FA) is frequently cancer resistance protein inhibition (IC50 > 500 mM).Incontrast, associated with myopathy including rhabdomyolysis upon coad- FA showed potent inhibition of OATP1B1- and OATP1B3-specific ministration with statins. Because adverse effects with statins are rosuvastatin transport with IC50 values of 1.59 mM and 2.47 mM, usually the result of drug–drug interactions, we evaluated the respectively. Furthermore, coadministration of oral rosuvastatin dmd.aspetjournals.org -
Antibiotic Resistance in Plant-Pathogenic Bacteria
PY56CH08-Sundin ARI 23 May 2018 12:16 Annual Review of Phytopathology Antibiotic Resistance in Plant-Pathogenic Bacteria George W. Sundin1 and Nian Wang2 1Department of Plant, Soil, and Microbial Sciences, Michigan State University, East Lansing, Michigan 48824, USA; email: [email protected] 2Citrus Research and Education Center, Department of Microbiology and Cell Science, Institute of Food and Agricultural Sciences, University of Florida, Lake Alfred, Florida 33850, USA Annu. Rev. Phytopathol. 2018. 56:8.1–8.20 Keywords The Annual Review of Phytopathology is online at kasugamycin, oxytetracycline, streptomycin, resistome phyto.annualreviews.org https://doi.org/10.1146/annurev-phyto-080417- Abstract 045946 Antibiotics have been used for the management of relatively few bacterial Copyright c 2018 by Annual Reviews. plant diseases and are largely restricted to high-value fruit crops because of Access provided by INSEAD on 06/01/18. For personal use only. All rights reserved the expense involved. Antibiotic resistance in plant-pathogenic bacteria has Annu. Rev. Phytopathol. 2018.56. Downloaded from www.annualreviews.org become a problem in pathosystems where these antibiotics have been used for many years. Where the genetic basis for resistance has been examined, antibiotic resistance in plant pathogens has most often evolved through the acquisition of a resistance determinant via horizontal gene transfer. For ex- ample, the strAB streptomycin-resistance genes occur in Erwinia amylovora, Pseudomonas syringae,andXanthomonas campestris, and these genes have pre- sumably been acquired from nonpathogenic epiphytic bacteria colocated on plant hosts under antibiotic selection. We currently lack knowledge of the effect of the microbiome of commensal organisms on the potential of plant pathogens to evolve antibiotic resistance. -
Live Biotherapeutic Products, a Road Map for Safety Assessment
Live Biotherapeutic Products, A Road Map for Safety Assessment Alice Rouanet, Selin Bolca, Audrey Bru, Ingmar Claes, Helene Cvejic, Haymen Girgis, Ashton Harper, Sidonie Lavergne, Sophie Mathys, Marco Pane, et al. To cite this version: Alice Rouanet, Selin Bolca, Audrey Bru, Ingmar Claes, Helene Cvejic, et al.. Live Biotherapeutic Products, A Road Map for Safety Assessment. Frontiers in Medicine, Frontiers media, 2020, 7, 10.3389/fmed.2020.00237. hal-02900344 HAL Id: hal-02900344 https://hal.inrae.fr/hal-02900344 Submitted on 8 Jun 2021 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Distributed under a Creative Commons Attribution| 4.0 International License POLICY AND PRACTICE REVIEWS published: 19 June 2020 doi: 10.3389/fmed.2020.00237 Live Biotherapeutic Products, A Road Map for Safety Assessment Alice Rouanet 1, Selin Bolca 2†, Audrey Bru 3†, Ingmar Claes 4†, Helene Cvejic 5,6†, Haymen Girgis 7†, Ashton Harper 8†, Sidonie N. Lavergne 9†, Sophie Mathys 10†, Marco Pane 11†, Bruno Pot 12,13†, Colette Shortt 14†, Wynand Alkema 15, Constance Bezulowsky 16, Stephanie Blanquet-Diot 17, Christophe Chassard 18, Sandrine P. Claus 19, Benjamin Hadida 20, Charlotte Hemmingsen 21, Cyrille Jeune 7, Björn Lindman 22, Garikai Midzi 8, Luca Mogna 11, Charlotta Movitz 22, Nail Nasir 23, 24 25 25 26 Edited by: Manfred Oberreither , Jos F. -
Challenges to Tackling Antimicrobial Resistance
Challenges to Tackling Antimicrobial Resistance Antimicrobial resistance (AMR) is a biological mechanism whereby a microorganism evolves over time to develop the ability to become resistant to antimicrobial therapies such as antibiotics. The drivers of and poten- tial solutions to AMR are complex, often spanning multiple sectors. The internationally recognized response to AMR advocates for a ‘One Health’ approach, which requires policies to be developed and implemented across human, animal, and environmental health. To date, misaligned economic incentives have slowed the development of novel antimicrobials and lim- ited efforts to reduce antimicrobial usage. However, the research which underpins the variety of policy options to tackle AMR is rapidly evolving across multiple disciplines such as human medicine, veterinary medicine, agricultural sciences, epidemiology, economics, sociology and psychology. By bringing together in one place the latest evidence and analysing the different facets of the complex problem of tackling AMR, this book offers an accessible summary for policy-makers, academics and students on the big questions around AMR policy. This title is also available as Open Access on Cambridge Core. Michael anderson is a Research Officer in Health Policy at the Department of Health Policy, London School of Economics and Political Science, and a Medical Doctor undertaking General Practice specialty training. Michele cecchini is a Senior Health Economist, Health Division, in the Directorate for Employment, Labour and Social Affairs, Organisation for Economic Co-operation and Development. elias Mossialos is Brian Abel-Smith Professor of Health Policy, Head of the Department of Health Policy at the London School of Economics and Political Science, and Co-Director of the European Observatory on Health Systems. -
Socioeconomic Factors Associated with Antimicrobial Resistance Of
01 Pan American Journal Original research of Public Health 02 03 04 05 06 Socioeconomic factors associated with antimicrobial 07 08 resistance of Pseudomonas aeruginosa, 09 10 Staphylococcus aureus, and Escherichia coli in Chilean 11 12 hospitals (2008–2017) 13 14 15 Kasim Allel,1 Patricia García,2 Jaime Labarca,3 José M. Munita,4 Magdalena Rendic,5 Grupo 16 6 5 17 Colaborativo de Resistencia Bacteriana, and Eduardo A. Undurraga 18 19 20 21 Suggested citation Allel K, García P, Labarca J, Munita JM, Rendic M; Grupo Colaborativo de Resistencia Bacteriana; et al. Socioeconomic fac- 22 tors associated with antimicrobial resistance of Pseudomonas aeruginosa, Staphylococcus aureus, and Escherichia coli in 23 Chilean hospitals (2008–2017). Rev Panam Salud Publica. 2020;44:e30. https://doi.org/10.26633/RPSP.2020.30 24 25 26 27 ABSTRACT Objective. To identify socioeconomic factors associated with antimicrobial resistance of Pseudomonas aeru- 28 ginosa, Staphylococcus aureus, and Escherichia coli in Chilean hospitals (2008–2017). 29 Methods. We reviewed the scientific literature on socioeconomic factors associated with the emergence and 30 dissemination of antimicrobial resistance. Using multivariate regression, we tested findings from the literature drawing from a longitudinal dataset on antimicrobial resistance from 41 major private and public hospitals and 31 a nationally representative household survey in Chile (2008–2017). We estimated resistance rates for three pri- 32 ority antibiotic–bacterium pairs, as defined by the Organisation for Economic Co-operation and Development; 33 i.e., imipenem and meropenem resistant P. aeruginosa, cloxacillin resistant S. aureus, and cefotaxime and 34 ciprofloxacin resistant E. coli. 35 Results. -
Pharmacokinetic and Pharmacodynamic Issues in the Treatment of Bacterial Infectious Diseases
Eur J Clin Microbiol Infect Dis (2004) 23: 271–288 DOI 10.1007/s10096-004-1107-7 Complete Table of Contents CURRENT TOPIC: REVIEW Subscription Information for P. S. McKinnon . S. L. Davis Pharmacokinetic and Pharmacodynamic Issues in the Treatment of Bacterial Infectious Diseases Published online: 10 March 2004 # Springer-Verlag 2004 Abstract This review outlines some of the many factors a gies to optimize antibiotic selection and dosing remain at clinician must consider when selecting an antimicrobial the forefront of our clinical research today. dosing regimen for the treatment of infection. Integration The appropriate use of antimicrobial agents requires an of the principles of antimicrobial pharmacology and the understanding of the characteristics of the drug, the host pharmacokinetic parameters of an individual patient factors, and the pathogen, all of which impact selection of provides the most comprehensive assessment of the the antibiotic agent and dose. Figure 1 illustrates the interactions between pathogen, host, and antibiotic. For complexity of the multiple interactions between the each class of agent, appreciation of the different patient, the pathogen, and the antibiotic. Characteristics approaches to maximize microbial killing will allow for of the patient that must be considered include those that optimal clinical efficacy and reduction in risk of develop- affect the interaction between the patient and the infection, ment of resistance while avoiding excessive exposure and such as comorbid factors and underlying immune status, as minimizing risk of toxicity. Disease states with special well as patient-specific factors such as organ function and considerations for antimicrobial use are reviewed, as are weight, which will impact the pharmacokinetics of the situations in which pathophysiologic changes may alter antibiotic. -
Healthcare Professionals' Knowledge of Pharmacogenetics and Attitudes
ORIGINAL RESEARCH published: 12 January 2021 doi: 10.3389/fphar.2020.551522 Healthcare Professionals’ Knowledge of Pharmacogenetics and Attitudes Towards Antimicrobial Utilization in Zambia: Implications for a Precision Medicine Approach to Reducing Antimicrobial Resistance Webrod Mufwambi 1,2,3, Julia Stingl 4, Collen Masimirembwa 2, Justen Manasa 2,3, Charles Nhachi 3, Nadina Stadler 5, Chiluba Mwila 1, Aubrey Chichonyi Kalungia 1*, Moses Mukosha 1, Chenai S. Mutiti 2,3, Alfred Kamoto 2,3, Patrick Kaonga 6,7, Edited by: Brian Godman 8,9,10 and Derick Munkombwe 1 Irene Lenoir-Wijnkoop, 1 2 Utrecht University, Netherlands Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia, African Institute of Biomedical Science and Technology, Harare, Zimbabwe, 3University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe, 4RWTH Reviewed by: University Hospital Aachen, Aachen, Germany, 5Research Division, Federal Institute for Drugs and Medical Devices, Bonn, Shazia Qasim Jamshed, Germany, 6Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia, International Islamic University 7Tropical Gastroenterology and Nutrition Group, School of Medicine, University of Zambia, Lusaka, Zambia, 8Division of Public Malaysia, Malaysia Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Rankuwa, South Africa, Oliver Van Hecke, 9Division of Clinical Pharmacology, Karolinska Institute, Stockholm, Sweden, 10Strathclyde Institute of Pharmacy and Biomedical University of Oxford, United Kingdom Sciences, University of Strathclyde, Glasgow, United Kingdom *Correspondence: Aubrey Chichonyi Kalungia [email protected] Introduction: Sub-Saharan Africa and other low- and middle-income countries (LMICs) have the highest rates of antimicrobial resistance (AMR) driven by high rates of Specialty section: antimicrobial utilization. -
Action and Resistance Mechanisms of Antibiotics: a Guide for Clinicians
J Anaesthesiol Clin Pharmacol. 2017 Jul-Sep; 33(3): 300–305. PMCID: PMC5672523 doi: 10.4103/joacp.JOACP_349_15: 10.4103/joacp.JOACP_349_15 PMID: 29109626 Action and resistance mechanisms of antibiotics: A guide for clinicians Garima Kapoor, Saurabh Saigal,1 and Ashok Elongavan2 Department of Microbiology, Gandhi Medical College, Bhopal, Madhya Pradesh, India 1Department of Trauma and Emergency, AIIMS, Bhopal, Madhya Pradesh, India 2Department of Critical Care Medicine, Columbia Asia Hospital, Bengaluru, Karnataka, India Address for correspondence: Dr. Garima Kapoor, Department of Microbiology, Gandhi Medical College, Bhopal, Madhya Pradesh, India. E-mail: [email protected] Copyright : © 2017 Journal of Anaesthesiology Clinical Pharmacology This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. Abstract Infections account for a major cause of death throughout the developing world. This is mainly due to the emergence of newer infectious agents and more specifically due to the appearance of antimicrobial resistance. With time, the bacteria have become smarter and along with it, massive imprudent usage of antibiotics in clinical practice has resulted in resistance of bacteria to antimicrobial agents. The antimicrobial resistance is recognized as a major problem in the treatment of microbial infections. The biochemical resistance mechanisms used by bacteria include the following: antibiotic inactivation, target modification, altered permeability, and “bypass” of metabolic pathway. Determination of bacterial resistance to antibiotics of all classes (phenotypes) and mutations that are responsible for bacterial resistance to antibiotics (genetic analysis) are helpful. -
The Antimicrobial Agent Fusidic Acid Inhibits Organic Anion Transporting
DMD Fast Forward. Published on February 17, 2016 as DOI: 10.1124/dmd.115.067447 This article has not been copyedited and formatted. The final version may differ from this version. DMD # 67447 The Antimicrobial Agent Fusidic Acid Inhibits Organic Anion Transporting Polypeptide-Mediated Hepatic Clearance and may Potentiate Statin-Induced Myopathy Heather Eng, Renato J. Scialis, Charles J. Rotter, Jian Lin, Sarah Lazzaro, Manthena V. Varma, Li Di, Bo Feng, Michael West, and Amit S. Kalgutkar Downloaded from Pharmacokinetics, Pharmacodynamics, and Metabolism Department – New Chemical Entities, dmd.aspetjournals.org Pfizer Inc., Eastern Point Road, Groton, CT (H.E., R.J.S., C.J.R., J.L., S.L., M.V.V., L.D., B.F., M.W.) and Cambridge MA (A.S.K.) at ASPET Journals on September 30, 2021 1 DMD Fast Forward. Published on February 17, 2016 as DOI: 10.1124/dmd.115.067447 This article has not been copyedited and formatted. The final version may differ from this version. DMD # 67447 Running Title: Drug-Drug interaction between statins and fusidic Acid Address correspondence to: Amit S. Kalgutkar, Pharmacokinetics, Dynamics, and Metabolism-New Chemical Entities, Pfizer Worldwide Research and Development, 610 Main Street, Cambridge, MA 02139, USA. Tel: +(617)-551-3336. E-mail: [email protected] Downloaded from Text Pages (including references): 38 Tables: 1 dmd.aspetjournals.org Figures: 5 References: 79 at ASPET Journals on September 30, 2021 Abstract: 247 Introduction: 624 Discussion: 1594 2 DMD Fast Forward. Published on February 17, 2016 as DOI: 10.1124/dmd.115.067447 This article has not been copyedited and formatted.