Review Article

Combination Therapy as a Strategy to Control Infections Caused by Multi-resistant Bacteria: Current Review

Author(s): Patricia Hernandez-Rodriguez* and Ludy P. Baquero

Volume 23, Issue 3, 2022

Published on: 14 June, 2021

Page: [260 - 265] Pages: 6

DOI: 10.2174/1389450122666210614122352

Price: $65

Abstract

Antimicrobial Resistance (AMR) is one of the main challenges of today's medicine because it has become a global problem that affects the treatment of multiple infections and impacts public health. This resistance is caused as the bacteria generate selective pressure-promoting mechanisms to evade the action of conventional drugs, which are also associated with adverse effects. Infections caused by these multi-resistant bacteria potentially reduce the possibility of effective therapy; this situation increases morbidity and mortality and treatment costs. Therefore, to establish combined therapy as a strategy for the control of infections caused by multi-resistant bacteria, a bibliographic search was carried out between 2015 and 2020 in databases such as PubMed, Scopus and Science Direct. The exhaustive review of the articles allowed a critical analysis of the information. Mechanisms were identified for obtaining drugs with antimicrobial potential, their biological activity and the possible effect of their combination against multidrug-resistant bacteria as an alternative for infectious disease control and as a response to reduce the use of antibiotics. Combined therapy is presented as an innovative therapeutic alternative, which uses non-antibiotic substances that can be obtained by three routes: the repositioning of drugs, synthetic substances and natural products. In this way, important elements are provided to guide researches that seek to reduce antimicrobial resistance.

Keywords: Antimicrobial resistance, infectious disease, drug combination, natural products, combined therapy, Synergisticeffects.

Graphical Abstract

[1]
Karine de Sousa A, Rocha JE, Gonçalves de Souza T, Sampaio de Freitas T, Ribeiro-Filho J, Melo Coutinho HD. New roles of fluoxetine in pharmacology: Antibacterial effect and modulation of antibiotic activity. Microb Pathog 2018; 123: 368-71.
[http://dx.doi.org/10.1016/j.micpath.2018.07.040] [PMID: 30056107]
[2]
Nørgaard SM, Jensen CS, Aalestrup J, Vandenbroucke-Grauls CMJE, de Boer MGJ, Pedersen AB. Choice of therapeutic interventions and outcomes for the treatment of infections caused by multidrug-resistant gram-negative pathogens: a systematic review. Antimicrob Resist Infect Control 2019; 8: 170.
[http://dx.doi.org/10.1186/s13756-019-0624-1] [PMID: 31709047]
[3]
Mikhail S, Singh NB, Kebriaei R, et al. Evaluation of the synergy of ceftazidime-avibactam in combination with meropenem, amikacin, aztreonam, colistin, or fosfomycin against well-characterized multidrug-resistant klebsiella pneumoniae and pseudomonas aeruginosa. Antimicrob Agents Chemother 2019; 63(8): e00779-819.
[http://dx.doi.org/10.1128/AAC.00779-19] [PMID: 31182535]
[4]
Djeussi DE, Noumedem JAK, Ngadjui BT, Kuete V. Antibacterial and antibiotic-modulation activity of six Cameroonian medicinal plants against Gram-negative multi-drug resistant phenotypes. BMC Complement Altern Med 2016; 16: 124.
[http://dx.doi.org/10.1186/s12906-016-1105-1] [PMID: 27142515]
[5]
Ibrahim YM, Abouwarda AM, Nasr T, Omar FA, Bondock S. Antibacterial and anti-quorum sensing activities of a substituted thiazole derivative against methicillin-resistant Staphylococcus aureus and other multidrug-resistant bacteria. Microb Pathog 2020; 149: 104500.
[http://dx.doi.org/10.1016/j.micpath.2020.104500] [PMID: 32926996]
[6]
Bezerra CF, Camilo CJ, do Nascimento Silva MK, de Freitas TS, Ribeiro-Filho J, Coutinho HDM. Vanillin selectively modulates the action of antibiotics against resistant bacteria. Microb Pathog 2017; 113: 265-8.
[http://dx.doi.org/10.1016/j.micpath.2017.10.052] [PMID: 29107747]
[7]
Schmid A, Wolfensberger A, Nemeth J, Schreiber PW, Sax H, Kuster SP. Monotherapy versus combination therapy for multidrug-resistant Gram-negative infections: Systematic Review and Meta-Analysis. Sci Rep 2019; 9(1): 15290.
[http://dx.doi.org/10.1038/s41598-019-51711-x]
[8]
Valcourt C, Saulnier P, Umerska A, et al. Synergistic interactions between doxycycline and terpenic components of essential oils encapsulated within lipid nanocapsules against gram negative bacteria. Int J Pharm 2016; 498(1-2): 23-31.
[http://dx.doi.org/10.1016/j.ijpharm.2015.11.042] [PMID: 26631640]
[9]
Oliveira MTA, Teixeira AMR, Cassiano CJM, et al. Modulation of the antibiotic activity against multidrug resistant strains of 4-(phenylsulfonyl) morpholine. Saudi J Biol Sci 2016; 23(1): 34-8.
[http://dx.doi.org/10.1016/j.sjbs.2015.02.001] [PMID: 26858536]
[10]
Luiz De Sousa Júnior D, Patrícia P, Cordeiro M, De Sousa Silveira Z, Macêdo NS, Boligon AA. Phytochemical profile of leaves extract of Azadirachta indica A. Juss and toxicity against Drosophila melanogaster 2018; Vol. 2 Available from: http://sciforum.net/conference/mol2net-02/wrsamc
[11]
Rao T, Tan Z, Peng J, et al. The pharmacogenetics of natural products: A pharmacokinetic and pharmacodynamic perspective. Pharmacol Res 2019; 146: 104283.
[http://dx.doi.org/10.1016/j.phrs.2019.104283] [PMID: 31129178]
[12]
Thomford NE, Senthebane DA, Rowe A, et al. Natural products for drug discovery in the 21st century: Innovations for novel drug discovery. Int J Mol Sci 2018; 19(6): 1578.
[http://dx.doi.org/10.3390/ijms19061578] [PMID: 29799486]
[13]
Vandevelde NM, Tulkens PM, Van Bambeke F. Modulating antibiotic activity towards respiratory bacterial pathogens by co-medications: a multi-target approach. Drug Discov Today 2016; 21(7): 1114-29.
[http://dx.doi.org/10.1016/j.drudis.2016.04.001] [PMID: 27094105]
[14]
Gómez-Junyent J, Benavent E, Sierra Y, et al. Efficacy of ceftolozane/tazobactam, alone and in combination with colistin, against multidrug-resistant Pseudomonas aeruginosa in an in vitro biofilm pharmacodynamic model. Int J Antimicrob Agents 2019; 53(5): 612-9.
[http://dx.doi.org/10.1016/j.ijantimicag.2019.01.010] [PMID: 30682497]
[15]
Horcajada JP, Montero M, Oliver A, et al. Epidemiology and treatment of multidrug-resistant and extensively drug-resistant Pseudomonas aeruginosa infections. Clin Microbiol Rev 2019; 32(4): e00031-19.
[http://dx.doi.org/10.1128/CMR.00031-19] [PMID: 31462403]
[16]
Morais-Braga MFB, Sales DL, dos Santos Silva F, Chaves TP, de Carvalho Nilo Bitu V, Avilez WMT. Psidium guajava L. and Psidium brownianum Mart ex DC. potentiate the effect of antibiotics against Gram-positive and Gram-negative bacteria. Eur J Integr Med 2016; 8(5): 683-7.
[http://dx.doi.org/10.1016/j.eujim.2016.07.001]
[17]
Gelmini F, Belotti L, Vecchi S, Testa C, Beretta G. Air dispersed essential oils combined with standard sanitization procedures for environmental microbiota control in nosocomial hospitalization rooms. Complement Ther Med 2016; 25: 113-9.
[http://dx.doi.org/10.1016/j.ctim.2016.02.004] [PMID: 27062958]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy