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Antibiotics
Special Issues
Progress and Challenges in the Antibiotic Treatment of Infections
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Progress and Challenges in the Antibiotic Treatment of Infections

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

Deadline for manuscript submissions: 24 August 2025 | Viewed by 1019

Special Issue Editor

Prof. Dr. Marina Bubonja-Sonje

E-Mail Website
Guest Editor
1. Department of Clinical Microbiology, Clinical Hospital Center Rijeka, Kresimirova 42, 51000 Rijeka, Croatia
2. Department of Microbiology and Parasitology, Faculty of Medicine, University of Rijeka, Brace Branchetta 20, 51000 Rijeka, Croatia
Interests: antibiotics; antimicrobial resistance (AMR); clinical microbiology; infectious disease diagnostics; medical education

Special Issue Information

Dear Colleagues,

The excessive and inappropriate use of antibiotics has led to increasing antimicrobial resistance (AMR), which undermines the effectiveness of antibiotics in the treatment of infectious diseases. Infections that were once easy to treat are now increasingly difficult to manage. The lack of effective antibiotics is making routine medical procedures such as surgery, chemotherapy, and organ transplantation a major health concern. An alarming increase in multi-drug resistant pathogens is making it more difficult to treat infections, prolonging hospital stays, and driving up healthcare costs. Improvements in diagnostics and antimicrobial stewardship are important strategies to combat AMR. The appropriate and effective use of existing antibiotics in combination with the use of rapid diagnostic tools is of paramount importance. Prioritising the development of novel antimicrobial therapeutic strategies can help to preserve the efficacy of antibiotics for future generations.

This Special Issue aims to explore the multifaceted challenges of antibiotic treatment in the context of increasing antimicrobial resistance. Submissions related to advances in the timely and accurate diagnosis of infectious diseases, AMR, and the judicious use of antibiotics are particularly encouraged. The aim of this Special Issue is to collect the latest experiences of all professionals working in this field.

Prof. Dr. Marina Bubonja-Sonje
Guest Editor

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

  • antimicrobial therapy
  • antimicrobial stewardship
  • antimicrobial resistance
  • rapid microbiological diagnostics

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Published Papers (2 papers)

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Research

18 pages, 958 KiB  
Article
First Report of CTX-M-32 and CTX-M-101 in Proteus mirabilis from Zagreb, Croatia
by Branka Bedenić, Josefa Luxner, Gernot Zarfel, Andrea Grisold, Mirela Dobrić, Branka Đuras-Cuculić, Mislav Kasalo, Vesna Bratić, Verena Dobretzberger and Ivan Barišić
Antibiotics 2025, 14(5), 462; https://doi.org/10.3390/antibiotics14050462 - 30 Apr 2025
Viewed by 105
Abstract
Background/Objectives: Proteus mirabilis is a frequent causative agent of urinary tract and wound infections in community and hospital settings. It develops resistance to expanded-spectrum cephalosporins (ESC) due to the production of extended-spectrum β-lactamases (ESBLs) or plasmid-mediated AmpC β-lactamases (p-AmpC). Here, we report the [...] Read more.
Background/Objectives: Proteus mirabilis is a frequent causative agent of urinary tract and wound infections in community and hospital settings. It develops resistance to expanded-spectrum cephalosporins (ESC) due to the production of extended-spectrum β-lactamases (ESBLs) or plasmid-mediated AmpC β-lactamases (p-AmpC). Here, we report the characteristics of ESBLs and p-AmpC β-lactamases encountered among hospital and community isolates of P. mirabilis in two hospitals and the community settings in Zagreb, Croatia. Methods: Antibiotic susceptibility testing was performed using disk-diffusion and broth dilution methods. The double-disk-synergy test (DDST) and inhibitor-based test with clavulanic and cloxacillin were applied to screen for ESBLs and p-AmpC, respectively. PCR investigated the nature of ESBL, carbapenemases, and fluoroquinolone resistance determinants. Selected strains were subjected to molecular analysis of resistance traits by the Inter-Array CarbaResist Kit and whole-genome sequencing (WGS). Results: In total, 39 isolates were analyzed. Twenty-two isolates phenotypically tested positive for p-AmpC and seventeen for ESBLs. AmpC-producing organisms exhibited uniform resistance to amoxicillin-clavulanate, ESC, ciprofloxacin, and sulphamethoxazole-trimethoprim, and uniform susceptibility to carbapenems and piperacillin-tazobactam and all harbored blaCMY-16 genes. ESBL-positive isolates demonstrated resistance to amoxicillin-clavulanate, cefuroxime, cefotaxime, ceftriaxone, and ciprofloxacin but variable susceptibility to cefepime and aminoglycosides. They possessed blaCTX-M genes that belong to cluster 1 (n = 5) or 9 (n = 12), with CTX-M-14 and CTX-M-65 as the dominant allelic variants. Conclusions: The study demonstrated the presence of CTX-M ESBL and CMY-16 p-AmpC among hospital and community-acquired isolates. AmpC-producing isolates showed uniform resistance patterns, whereas ESBL-positive strains had variable degrees of susceptibility/resistance to non-β-lactam antibiotics, resulting in more diverse susceptibility patterns. The study found an accumulation of various resistance determinants among hospital and outpatient isolates, mandating improvement in detecting β-lactamases during routine laboratory work. Full article
(This article belongs to the Special Issue Progress and Challenges in the Antibiotic Treatment of Infections)
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21 pages, 783 KiB  
Article
A Biosocial Perspective to Understand Antimicrobial Prescription Practices: A Retrospective Cross-Sectional Study from a Public Community Health Center in North India
by Rashmi Surial, Sundeep Sahay, Vinay Modgil, Arunima Mukherjee and Ritika Kondal Bhandari
Antibiotics 2025, 14(3), 213; https://doi.org/10.3390/antibiotics14030213 - 20 Feb 2025
Viewed by 667
Abstract
Background: It is well established by research that large-scale and indiscriminate prescribing, dispensing, and use of antimicrobials drive antimicrobial resistance (AMR) endangering the health and well-being of people, animals, and the environment. In the context of low- and middle-income countries (LMICs), the prescribing [...] Read more.
Background: It is well established by research that large-scale and indiscriminate prescribing, dispensing, and use of antimicrobials drive antimicrobial resistance (AMR) endangering the health and well-being of people, animals, and the environment. In the context of low- and middle-income countries (LMICs), the prescribing of antimicrobials is often not based on biomedical rationality but involves alternative logic driven by social, cultural, and institutional factors. This paper seeks to develop a “biosocial” perspective, reflecting a unified perspective that treats the biomedical and social conditions as two sides of the same coin. Methods: This analysis is based on an empirical investigation of prescription slips that patients carry to buy drugs from the pharmacy following an outpatient department encounter with the clinician. Data collection involves mixed methods, including the quantitative analysis of the antimicrobials prescribed and a qualitative analysis of the underlying reasons for these prescriptions, as described by doctors, pharmacists, and patients. Data analysis involved triangulating quantitative and qualitative data, to develop a “biosocial” perspective, which can provide implications for the development of antimicrobial stewardship policies, particularly relevant for health institutions in low- and middle-income countries. Results: Our analysis of 1175 prescription slips showed that 98% contained antimicrobials, with 74% being broad-spectrum antimicrobials. Only 9% of cases were advised antimicrobial sensitivity testing (AST) before initiating treatment. Qualitative findings indicated that patients had poor awareness of antimicrobials and pharmacists played a crucial role in counseling. Conclusions: This study highlights that antimicrobial prescriptions in public health settings are influenced by both biomedical and social factors, supporting a biosocial perspective. Although AMS interventions are predominantly biomedical, adhering to clinical standards and best practices, this study underscores the necessity of integrating a biosocial viewpoint by incorporating the experiences of pharmacists and patient groups. Strengthening diagnostic support, patient education, and interprofessional collaboration could improve rational antimicrobial uses in low-resource settings. Full article
(This article belongs to the Special Issue Progress and Challenges in the Antibiotic Treatment of Infections)
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