Frontline antibiotic therapy

Abstract

-The need to use front-line antibiotics wisely has never been greater. Antibiotic resistance and multi-drug resistant infection, driven by antibiotic use, remain major public health and professional concerns. To overcome these infection problems, use of older antibiotics active against multidrug-resistant pathogens is increasing -for example, colistin, fosfomycin, pivmecillinam, pristinamycin, temocillin and oral tetracyclines. The number of new antibacterials reaching clinical practice has reduced significantly in the last 20 years, most being focused on therapy of Grampositive infection -eg linezolid, daptomycin, telavancin and ceftaroline. Recent guidance on antibiotic stewardship in NHS trusts in England is likely to provide a backdrop to antibiotic use in hospitals in the next 5 years.

Why does drug resistance readily evolve but vaccine resistance does not?

“…For instance, most Staphylococcus aureus isolates in British hospitals were resistant to penicillin just 6 years after the introduction of the drug [13]. Similar evolutionary trajectories have been observed for the vast majority of drugs [14] and today many drugs are clinically useless against particular pathogens [15]. The problem has become so acute that drug resistance is viewed as one of the great challenges of our age, ranking alongside climate change and surpassing terrorism [16].…”

The re-emergence of natural products for drug discovery in the genomics era

“…The current rate of the introduction of new antimicrobials may not be sufficient to cope with the emergence of bacteria and fungi that are resistant to available agents [196][197][198][199] . The situation is particularly acute in the case of drug-resistant Gram-negative bacterial infections, because very few new compounds are in development for such uses 200 .…”

Crystal structure and activities of three biscoumarin derivatives against Staphylococcus aureus

“…The number of new antibacterials reaching clinical practice has significantly reduced in the last 20 years. Linezolid and daptomycin are the only two new antibiotics whose structures are different compared with previous antibiotics, and daptomycin bacterial resistance has not been solved since the development of the drug in 2003 [30]. Biscoumarins are widely distributed in nature and exhibit a broad pharmacological profile.…”