Drug resistance in community-acquired respiratory tract infections: role for an emerging antibacterial

Abstract

The nasopharynx is the ecological niche where evolution towards resistance occurs in respiratory tract isolates. Dynamics of different bacterial populations in antibiotic-free multibacterial niches are the baseline that antibiotic treatments can alter by shifting the competitive balance in favor of resistant populations. For this reason, antibiotic resistance is increasingly being considered to be an ecological problem. Traditionally, resistance has implied the need for development of new antibiotics for which basic efficacy and safety data are required prior to licensing. Antibiotic development is mainly focused on demonstrating clinical efficacy and setting susceptibility breakpoints for efficacy prediction. However, additional information on pharmacodynamic data predicting absence of selection of resistance and of resistant subpopulations, and specific surveillance on resistance to core antibiotics (to detect emerging resistances and its link with antibiotic consumption in the community) are valuable data in defining the role of a new antibiotic, not only from the perspective of its therapeutic potential but also from the ecologic perspective (countering resistances to core antibiotics in the community). The documented information on cefditoren gleaned from published studies in recent years is an example of the role for an emerging oral antibacterial facing current antibiotic resistance in community-acquired respiratory tract infections.

Scientific evidence for health effects attributed to the consumption of probiotics and prebiotics: an update for current perspectives and future challenges

“…This condition, common among children, is normally self-limiting, and the risk for the development of complications is considered small ( 92 ) . Antibiotics are commonly used in an inappropriate manner for the treatment of the pathology and may therefore select resistant micro-organisms, an increasing global phenomenon ( 93 , 94 ) .…”

Revisiting cefditoren for the treatment of community-acquired infections caused by human-adapted respiratory pathogens in adults

“…Revisiting cefditoren pharmacokinetic/ pharmacodynamic (PK/PD) data to interpret susceptibility [69][70][71] Fortunately, cefditoren is a drug with high number of pharmacodynamic studies published in the literature. Pharmacodynamics constitute one of the major basis for setting breakpoints by Regulatory Agencies [72].…”

Erythromycin Resistance in Bacterial Isolates from Patients with Respiratory Tract Infections in Ikere-Ekiti, Nigeria

“…Inhalation of infectious pathogens introduced into the air via sneezing, coughing, or talking from an infected person, indirect transmission via sharing of cups, and other eating utensils with an infected person has also been implicated (Jafari et al, 2009). Respiratory tract infections (RTIs) are considered an important public health problem as they are responsible for over 50 million deaths annually in health care and community settings (Aguilar et al, 2010) which is widespread across people of all ages. The most frequently documented and common RTIs include pharyngitis, laryngitis, sore throat, bronchitis, tuberculosis, whooping cough (pertussis), emphysema, pneumonia, mastoiditis, otitis media, and the common cold, etc.…”

“…The emergence of antimicrobial resistance among the common bacterial pathogens has currently complicated the therapeutic use of macrolides. Therefore, a definitive bacteriological investigation and susceptibility pattern would be necessary for efficacious treatment (Aguilar et al, 2010). The burden of respiratory diseases is not well studied particularly in developing countries where treatment of respiratory tract infection is based on empirical therapy, probably due to increased cost of laboratory services and high levels of poverty.…”