Antibiotic combination therapy against resistant bacterial infections: synergy, rejuvenation and resistance reduction
Antibiotic combination therapy against resistant bacterial infections: synergy, rejuvenation and resistance reduction
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DOI：
10.1080/14787210.2020.1705155
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发表时间：
2020-01-02
影响因子：
5.7
通讯作者：
Yeh, Pamela
中科院分区：
文献类型：
--
作者：
Coates, Anthony R. M.;Hu, Yanmin;Yeh, Pamela
引言：抗微生物药物耐药性（AMR）是一场威胁现代医学的大流行。由于新型抗生素单一疗法进展缓慢、成本高昂且可实现的销售价格较低，缺乏有效的药物治疗。抗生素联合疗法带来了新的希望，虽然这是大自然母亲所采用的方式，但尚未得到充分探索，且可能为抗微生物药物耐药性提供解决方案。
涵盖领域：我们使用“联合疗法”“抗微生物药物耐药性”等关键词在PubMed和Medline上对1930年至2019年间的文章进行了检索，并根据我们的知识补充了其他相关参考文献。我们回顾了联合用药研发的理论考量，并研究了联合疗法现有的和未来的临床适应证。我们讨论了抗生素联合使用产生治疗协同作用的潜力，使细菌先前已产生耐药性的旧抗生素恢复效力。我们研究了当前关于使用联合疗法降低耐药性的思路和证据，并综述了毒性和药物相互拮抗作用。
专家意见：利用协同作用、旧药恢复效力和降低耐药性的抗生素联合疗法可能为抗微生物药物耐药性提供解决方案。该领域的制药公司数量可能会增加，将有前景的联合用药方案带到临床，拯救全球数百万人的生命。
Introduction: Anti-Microbial Resistance (AMR) is a pandemic which threatens modern medicine. There is a lack of effective drug treatment due to the slow pace, high cost and low achievable sales prices of new antibiotic monotherapies. New hope comes in the shape of antibiotic combination therapy, which although used by mother nature, is under-explored and could provide the solution to AMR. Areas covered: We performed a search of Pubmed and Medline using the keywords 'combination therapy', 'antimicrobial resistance' for articles between 1930 and 2019, as supplemented with other relevant references to our knowledge. We have reviewed the theoretical considerations for combination development and examine the existing and future clinical indications of combination therapies. We have discussed the potential of antibiotic combinations to provide therapeutic synergy, rejuvenating the effectiveness of old antibiotics to which the bacteria had developed resistance previously. We have examined the current thinking and evidence on resistance reduction using combination therapies, with a review on toxicity and drug-drug antagonism. Expert opinion: Antibiotic combination therapy, exploiting synergies, old-drug rejuvenation and resistance reduction could provide the solution to AMR. The number of pharmaceutical companies in this area is likely to expand, bringing promising combinations to the bedside, to save millions of lives worldwide.