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Tigecycline is approved for the treatment of cSSSI and cIAI infections. To date, little resistance to tigecycline has been reported; however, with widespread use of the drug, resistance will likely occur. Since published studies have not dealt with seriously ill patients, it is recommended that, until further studies have been completed, other agents be used in the treatment of these patients unless no option other than tigecycline exists.

Research AbstractIn Thailand, traditional plant-based medicines have always been used to treat gastrointestinal ailments, including gastritis, peptic ulcer disease (PUD) and diarrhea. Since Helicobacter pylori (HP) is an etiological agent of PUD, we have used an ethnomedical approach for screening plant extracts as potential treatments for HP infections, including over 20 species from Thailand. International Memoranda of Agreement were established between UIC and Mahidol University in Thailand. Medicinal plants were collected, identified and extracted. Susceptibility testing was performed with 15 HP strains using the agar dilution procedure guidelines of the Clinical and Laboratory Standards Institute. In vivo studies included evaluating bacterial load, as well as acute and chronic inflammation in HPinfected Mongolian gerbils. Extracts of Curcuma longa L. and Boesenbergia rotunda (L.) Mansf. significantly reduced HP-induced gastric lesions, as assessed both macroscopically and microscopically in Mongolian gerbils. The treatments reduced acute and/or chronic inflammation in a prevention model of HP-induced gastritis.

It is often said that the marketplace for new antibiotics is broken. This notion is supported by the observation that many recently-approved antibiotics to treat drug-resistant bacteria have failed commercially in a spectacular fashion. Today, companies with peak market-cap values in excess of USD 500 million to 1 billion prior to product launch regularly sell for pennies on the dollar a few years after market introduction. It is possible, however, that the market is not as broken as we perceive. That is, in the collective mind of the clinician, recently-approved antibiotics may be too-poorly differentiated to justify their broad use and inordinate cost relative to those already existing. Perhaps we in the antibacterial drug development field must change our way of thinking if we are to survive and thrive. Rather than reflexively developing new β-lactam-β-lactamase inhibitor combinations for every new enzyme that evades our current inhibitors, we should focus discovery and development efforts on agents that revolutionize how we potentiate antibiotics. To this end, there has been renewed interest in phage therapies, virulence inhibitors, bacterial growth rate modulators, monoclonal antibodies, and other approaches to augment antibiotic effects. Herein, we suggest that the unmet medical need is less about adding poorly-differentiated antibiotics to our armamentarium and more about the need for innovation in how we augment antibiotic regimen effects.