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Antibiotics
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Antibiotics and Infectious Respiratory Diseases, 2nd Edition
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Antibiotics and Infectious Respiratory Diseases, 2nd Edition

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 9255

Special Issue Editors

Prof. Dr. Francesco Di Gennaro

E-Mail Website
Guest Editor
Clinic of Infectious Diseases, University of Bari, 70121 Bari, Italy
Interests: HIV; tuberculosis; NTM; malaria; antimicrobial resistance; HCV; HBV; SARS CoV2; COVID-19; infectious diseases
Special Issues, Collections and Topics in MDPI journals
Dr. Fabrizio Palmieri

E-Mail Website
Guest Editor
Director of Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, 00149 Rome, Italy
Interests: infectious diseases; respiratory infectious diseases; pulmonary tuberculosis; COVID-19 pneumonia; antibiotic use and resistance
Special Issues, Collections and Topics in MDPI journals
Dr. Gina Gualano

E-Mail
Guest Editor
Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, 00149 Rome, Italy
Interests: infectious diseases; respiratory infectious diseases; pulmonary tuberculosis; COVID-19 pneumonia; antibiotic use and resistance; NTM
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Infectious respiratory diseases (IRD) continue to be among the leading causes of morbidity and mortality globally, and in the age of the COVID-19 pandemic, they have gained prominence in the scientific community and the global health approach. They can be caused by viruses, bacteria, parasites, or opportunistic infections; nevertheless, indiscriminate antibiotic usage in their treatment has resulted in the development of antimicrobial resistance. The effective management of respiratory infectious illnesses in order to lessen their burden and avoid antibiotic misuse has become a major therapeutic and public health concern. Manuscripts covering all areas of IRD prevention, diagnosis, management, and therapy are encouraged. We are interested in either reviews (literature reviews or systematic reviews), prospective or retrospective studies or case studies.

Manuscripts addressing the following topics are also welcome:

  1. Antimicrobial resistance and bacterial host resistance;
  2. New antibiotics for MDR infection;
  3. HAP (hospital-acquired pneumonia), VAP (ventilator-associated pneumonia), and CAP (community-acquired pneumonia) are the three types of pneumonia;
  4. Nontuberculous mycobacteria (NTM) and tuberculosis;
  5. SARS CoV2 interstitial pneumonia and viral pneumonia;
  6. Antimicrobial resistance and antimicrobial prescription education;
  7. Infection with pneumonia in immunocompetent and immunocompromised people.

Prof. Dr. Francesco Di Gennaro
Dr. Fabrizio Palmieri
Dr. Gina Gualano
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • infectious respiratory diseases
  • pulmonary tuberculosis
  • COVID-19 pneumonia
  • antibiotic use and resistance
  • gram negative
  • gram positive
  • pneumonia opportunistic infection
  • multidrug resistance (MDR)
  • medical education
  • infection prevention control

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Published Papers (5 papers)

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15 pages, 1221 KiB  
Article
Effects of Anti-Pseudomonal Agents, Individually and in Combination, With or Without Clarithromycin, on Growth and Biofilm Formation by Antibiotic-Susceptible and -Resistant Strains of Pseudomonas aeruginosa, and the Impact of Exposure to Cigarette Smoke Condensate
by Moloko C. Cholo, Charles Feldman, Ronald Anderson, Lebogang Sekalo, Naledi Moloko and Guy A. Richards
Antibiotics 2025, 14(3), 325; https://doi.org/10.3390/antibiotics14030325 - 19 Mar 2025
Viewed by 393
Abstract
Background/Objectives: Pseudomonas aeruginosa (Psa) can circumvent antimicrobial chemotherapy, an ability enhanced by cigarette smoking (CS). This study probed potential benefits of combinations of anti-pseudomonal agents, and potential augmentation by a macrolide, in the absence or presence of cigarette smoke condensate [...] Read more.
Background/Objectives: Pseudomonas aeruginosa (Psa) can circumvent antimicrobial chemotherapy, an ability enhanced by cigarette smoking (CS). This study probed potential benefits of combinations of anti-pseudomonal agents, and potential augmentation by a macrolide, in the absence or presence of cigarette smoke condensate (CSC). Methods: Two susceptible (WT: wild-type and DS: drug-sensitive) and one multidrug-resistant (MDR) strains of Psa were treated with amikacin, cefepime, and ciprofloxacin, individually and in combination, and with and without clarithromycin, followed by the measurement of planktonic growth and biofilm formation by spectrophotometry. Antibiotic interactions were determined using the fractional inhibitory concentration index (FICI) method. Effects on preformed biofilm density were measured following the addition of antibiotics: all procedures were performed in the absence and presence of CSC. Results: The minimal inhibitory concentrations (MICs) of the three agents ranged from 0.125 mg/L to 1 mg/L (WT and DS strains) and 16 mg/L to 64 mg/L (MDR strain), with all resistant to clarithromycin (125 mg/L). MIC values closely correlated with the antibiotic concentrations required to inhibit biofilm formation. FICI revealed synergism between most combinations, with augmentation by clarithromycin. Amikacin had the greatest effect on biofilm density, which was potentiated by combination with the other antibiotics, particularly clarithromycin. Exposure to CSC had variable, albeit modest, effects on bacterial growth and biofilm formation, but low concentrations increased biofilm mass and attenuated synergistic antimicrobial interactions and effects on biofilm density. Conclusions: Amikacin, cefepime, and ciprofloxacin, especially with clarithromycin, exhibit synergistic anti-pseudomonal activity and decrease preformed biofilm density. CSC attenuated these effects, illustrating the pro-infective potential of CS. Full article
(This article belongs to the Special Issue Antibiotics and Infectious Respiratory Diseases, 2nd Edition)
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17 pages, 863 KiB  
Article
Identification of Factors Determining Patterns of Serum C-Reactive Protein Level Reduction in Response to Treatment Initiation in Patients with Drug-Susceptible Pulmonary Tuberculosis
by Agnija Kivrane, Viktorija Ulanova, Solveiga Grinberga, Eduards Sevostjanovs, Anda Viksna, Iveta Ozere, Ineta Bogdanova, Ilze Simanovica, Inga Norvaisa, Leonora Pahirko, Dace Bandere and Renate Ranka
Antibiotics 2024, 13(12), 1216; https://doi.org/10.3390/antibiotics13121216 - 14 Dec 2024
Viewed by 1187
Abstract
Background: Serum C-reactive protein (CRP) levels vary depending on radiological and bacteriological findings at the time of tuberculosis (TB) diagnosis. However, the utility of this biomarker in monitoring response to anti-TB treatment and identifying patients at risk of treatment failure is not well [...] Read more.
Background: Serum C-reactive protein (CRP) levels vary depending on radiological and bacteriological findings at the time of tuberculosis (TB) diagnosis. However, the utility of this biomarker in monitoring response to anti-TB treatment and identifying patients at risk of treatment failure is not well established. Objectives: This study evaluated the impact of patients’ baseline characteristics and anti-TB drug plasma exposure on the early reduction in serum CRP levels and its relationship with treatment response. Methods: We enrolled 42 patients with drug-susceptible pulmonary TB, who received a standard six-month regimen. The plasma concentrations of four anti-TB drugs were analysed using LC-MS/MS. Clinically relevant data, including serum CRP levels before and 10–12 days after treatment initiation (CRP10–12d), were obtained from electronic medical records and patient questionnaires. Results: In 10–12 days, the median serum CRP level decreased from 21.9 to 6.4 mg/L. Lower body mass index, positive sputum-smear microscopy results, and lung cavitations at diagnosis were related to higher biomarker levels at both time points; smoking had a more pronounced effect on serum CRP10–12d levels. Variability in anti-TB drug plasma exposure did not significantly affect the reduction in serum CRP levels. The serum CRP10–12d levels, or fold change from the baseline, did not predict the time to sputum culture conversion. Conclusions: Disease severity and patient characteristics may influence the pattern of early CRP reduction, while anti-TB drug plasma exposure had no significant effect at this stage. These early changes in serum CRP levels were not a predictor of response to anti-TB therapy. Full article
(This article belongs to the Special Issue Antibiotics and Infectious Respiratory Diseases, 2nd Edition)
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14 pages, 1369 KiB  
Article
Impact of a Pro-Active Infectious Disease Consultation on the Management of a Multidrug-Resistant Organisms Outbreak in a COVID-19 Hospital: A Three-Months Quasi-Experimental Study
by Davide Fiore Bavaro, Nicolò De Gennaro, Alessandra Belati, Lucia Diella, Roberta Papagni, Luisa Frallonardo, Michele Camporeale, Giacomo Guido, Carmen Pellegrino, Maricla Marrone, Alessandro Dell’Erba, Loreto Gesualdo, Nicola Brienza, Salvatore Grasso, Giuseppe Columbo, Antonio Moschetta, Giovanna Elisiana Carpagnano, Antonio Daleno, Anna Maria Minicucci, Giovanni Migliore and Annalisa Saracinoadd Show full author list remove Hide full author list
Antibiotics 2023, 12(4), 712; https://doi.org/10.3390/antibiotics12040712 - 6 Apr 2023
Cited by 3 | Viewed by 2191
Abstract
Background: Antimicrobial and diagnostic stewardship (AS/DS) principles are crucial for the management of multidrug-resistant organisms (MDROs) infections. We evaluated the impact of a pro-active Infectious Disease (ID) consultation on the mortality risk of patients during an MDROs outbreak in a COVID-19 hospital. Methods: [...] Read more.
Background: Antimicrobial and diagnostic stewardship (AS/DS) principles are crucial for the management of multidrug-resistant organisms (MDROs) infections. We evaluated the impact of a pro-active Infectious Disease (ID) consultation on the mortality risk of patients during an MDROs outbreak in a COVID-19 hospital. Methods: A quasi-experimental study was performed in a dedicated COVID-19 hospital, including patients with suspected/confirmed infection and/or colonization by MDROs, which were managed as follows: (i) according to the standard of care during the pre-phase and (ii) in collaboration with a dedicated ID team performing a pro-active bedside evaluation every 48–72 h in the post-phase. Results: Overall, 112 patients were included (pre-phase = 89 and post-phase = 45). The AS interventions included the following: therapy optimization (33%), de-escalation to narrow the spectrum (24%) or to lessen toxic drugs (20%), and discontinuation of antimicrobials (64%). DS included the request of additional microbiologic tests (82%) and instrumental exams (16%). With the Cox model, after adjusting for age, sex, COVID-19 severity, infection source, etiological agents, and post-phase attendance, only age predicted an increased risk of mortality, while attendance in the post-phase resulted in a decreased risk of mortality. Conclusions: Implementation of AS and DS intervention through a pro-active ID consultation may reduce the risk of 28-day mortality of COVID-19 patients with MDROs infections. Full article
(This article belongs to the Special Issue Antibiotics and Infectious Respiratory Diseases, 2nd Edition)
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10 pages, 874 KiB  
Article
Nurses’ Knowledge, Attitudes and Practices on the Management of Clostridioides difficile Infection: A Cross-Sectional Study
by Dania Comparcini, Valentina Simonetti, Francesco Vladimiro Segala, Francesco Di Gennaro, Davide Fiore Bavaro, Maria Antonietta Pompeo, Annalisa Saracino and Giancarlo Cicolini
Antibiotics 2023, 12(3), 529; https://doi.org/10.3390/antibiotics12030529 - 7 Mar 2023
Cited by 5 | Viewed by 2669
Abstract
Clostridioides difficile is, worldwide, the leading cause of hospital-acquired infection. Outbreaks are largely related to antibiotic exposure and contact contamination, but little is known about C. difficle infection (CDI) awareness in the nurse population. We conducted a cross-sectional survey to study Italian nurses, [...] Read more.
Clostridioides difficile is, worldwide, the leading cause of hospital-acquired infection. Outbreaks are largely related to antibiotic exposure and contact contamination, but little is known about C. difficle infection (CDI) awareness in the nurse population. We conducted a cross-sectional survey to study Italian nurses, based on CDI guidelines. We recruited 200 nurses working in 14 Italian hospitals. Using a one-way analysis of variance of knowledge scores, female nurses (mean 9.67 (standard deviation ± 1.63), p = 0.03), and nurses with a higher level of university education (mean 9.79 (SD ± 1.67), p = 0.04) were demonstrated to have better knowledge about CDI. In addition, 92.5% (n = 184) of the sample declared that they did not have specific postgraduate training about CDI. Seventy-four percent (n = 149) of the respondents declared that they used procedures, protocols and guidelines about CDI in their workplace, but only 46.5% (n = 93) reported using C. difficile-specific bundles during their daily practice. In conclusion, our study highlights a lack of knowledge concerning CDI clinical guidelines among Italian nurses. Full article
(This article belongs to the Special Issue Antibiotics and Infectious Respiratory Diseases, 2nd Edition)
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8 pages, 1482 KiB  
Case Report
Diagnosis of Tuberculosis in a Case of Chronic Urticaria following Omalizumab Therapy
by Alberto Zolezzi, Gina Gualano, Maria A. Licata, Silvia Mosti, Paola Mencarini, Roberta Papagni, Antonella Vulcano, Angela Cannas, Alberta Villanacci, Fabrizio Albarello, Franca Del Nonno, Daniele Colombo and Fabrizio Palmieri
Antibiotics 2023, 12(12), 1655; https://doi.org/10.3390/antibiotics12121655 - 24 Nov 2023
Viewed by 1857
Abstract
In Italy, tuberculosis (TB) incidence in the last decade has remained constant at under 10 cases/100,000 inhabitants. In the Philippines, TB annual incidence is greater than 500 cases/100,000 inhabitants. Omalizumab is a humanized anti-IgE monoclonal antibody approved for the treatment of chronic spontaneous [...] Read more.
In Italy, tuberculosis (TB) incidence in the last decade has remained constant at under 10 cases/100,000 inhabitants. In the Philippines, TB annual incidence is greater than 500 cases/100,000 inhabitants. Omalizumab is a humanized anti-IgE monoclonal antibody approved for the treatment of chronic spontaneous urticaria. We report the case of a 32-year-old Filipino woman who suffered from chronic urticaria, treated with topic steroids since June 2022 and systemic steroids for 2 weeks. In November 2022, she started omalizumab therapy at a monthly dose of 300 mg; she was not screened for TB infection. In the same month, a left laterocervical lymphadenopathy arose, which worsened in February 2023 (diameter: 3 cm). The patient recovered in April 2023 in INMI “Lazzaro Spallanzani” in Rome for suspected TB. Chest CT showed a “tree in bud” pattern at the upper-right pulmonary lobe. The patient tested positive for lymph node biopsy molecular tuberculosis. The patient started standard antituberculosis therapy. She discontinued omalizumab. To our knowledge, this is the second diagnosed TB case during omalizumab treatment, which suggests that attention should be paid to the known risk of TB during biotechnological treatments. Even if current guidelines do not recommend screening for TB before starting anti-IgE therapy, further data should be sought to assess the relationship between omalizumab treatment and active TB. Our experience suggests that screening for TB should be carried out in patients from highly tuberculosis-endemic countries before starting omalizumab therapy. Full article
(This article belongs to the Special Issue Antibiotics and Infectious Respiratory Diseases, 2nd Edition)
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