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Counteracting antibiotic resistance: Breaking barriers among antibacterial strategies

机译:对抗抗生素耐药性:打破抗菌策略中的障碍

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Introduction: To fight against antibiotic resistance, prevention-only is no longer an acceptable strategy. The old concept 'one-infection, one-bug, one-drug', genocentrism in antibiotic discovery, and lack of integration between different antimicrobial strategies have probably contributed to current weaknesses in confronting antibiotic resistance. Resistance should be combatted in all fronts simultaneously, in the patient (complex therapy), the group (where resistance is maintained), and the significant environment (polluted by resistance).Areas covered: This paper is reviewing why specific 'therapeutic' approaches are needed in each of these fronts, using different types of 'drugs' directed to a variety of targets, in the goal of inhibiting antibiotic resistant bacteria. Multi-target integrated combination strategies and therapies should be more extensively evaluated, not only in the infected patient (using novel formats for clinical trials), but as associations of 'therapeutic strategies' in the different compartments where antibiotic resistance emerges and flows (measuring global effects in resistance).Expert opinion: Multi-targeted therapeutic approaches require a relaxation of barriers among the various compounds, including systemic and topic antibiotics, antiseptics, biocides, anti-resistant clones vaccination, phages, decontamination products, and in general eco-evo drugs acting on factors influencing ecology and evolution of resistant bacteria. The application of methods of systems biology will facilitate such a multi-lateral attack to antibiotic resistance. Such advances should be paralleled by a simultaneous progress in regulatory sciences and close coordination among all stakeholders.
机译:简介:为了对抗抗生素耐药性,仅预防已不再是可接受的策略。古老的概念“一感染,一虫,一药”,抗生素发现中的基因中心主义以及不同抗菌策略之间缺乏整合,可能导致了目前面对抗生素耐药性的弱点。在患者(复杂治疗),患者组(维持耐药性)和重要环境(受到耐药性污染)的各个方面应同时进行耐药性研究。覆盖范围:本文回顾了为何采用特定的“治疗”方法为了抑制抗生素抗性细菌,这些方面都需要针对不同目标使用不同类型的“药物”。多靶点综合联合策略和疗法应不仅在受感染的患者中(使用新颖的形式用于临床试验)进行更广泛的评估,而且还应作为“治疗策略”在不同抗生素耐药性出现和流动的区域中的关联(测量总体专家意见:多目标治疗方法要求放宽各种化合物之间的屏障,包括全身和局部抗生素,防腐剂,杀生物剂,抗性克隆疫苗接种,噬菌体,去污产品以及一般而言的生态进化作用于影响抗性细菌生态和进化的因素的药物。系统生物学方法的应用将促进对抗生素耐药性的这种多边攻击。这些进步应与监管科学的同时进步和所有利益相关者之间的密切协调并驾齐驱。

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