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Antibiotics
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Antibiotic Therapy in Respiratory Tract Infections (RTIs)
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Antibiotic Therapy in Respiratory Tract Infections (RTIs)

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

Deadline for manuscript submissions: 2 March 2026 | Viewed by 4013

Special Issue Editors

Dr. Ágnes Tóth

E-Mail Website
Guest Editor
Department of Integrative Health Sciences, Institute of Health Sciences, Faculty of Health Sciences, University of Debrecen, 4028 Debrecen, Hungary
Interests: antibiotics; antimicrobial resistance; respiratory diseases; microbiome; public health
Prof. Dr. Attila Csaba Nagy

E-Mail Website
Guest Editor
Department of Health Informatics, Institute of Health Sciences, Faculty of Health Sciences, University of Debrecen, 4028 Debrecen, Hungary
Interests: epidemiology; biostatistics; machine learning; health science; public health

Special Issue Information

Dear Colleagues,

Respiratory tract infections (RTIs) are among the most common infectious diseases worldwide and represent a major global health burden. They cause significant morbidity, mortality, and healthcare costs worldwide. Antibiotic therapy remains key for the treatment of RTIs, but its use is often restricted by the growing threat of antimicrobial resistance due to overuse, inadequate prescribing practices, and diagnostic difficulties.

This special issue will explore the challenges and recent developments in antibiotic therapy for RTIs, including novel diagnostic tools, different aspects of RTI management, optimized dosing strategies, the effectiveness of innovations in the fight against antibiotic resistance in RTIs, mechanisms of resistance, impacts on host immunity and microbiome dynamics, antibiotic stewardship initiatives, and public health interventions.

Sharing results from this area of research will provide valuable insights into current clinical practices, barriers to compliance, and innovative strategies for improving patient care and therapeutic outcomes while mitigating risks associated with inappropriate antibiotic utilization.

Dr. Ágnes Tóth
Prof. Dr. Attila Csaba Nagy
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

  • antibiotic therapy
  • respiratory tract infections
  • clinical guidelines
  • prescribing practices
  • antibacterial resistance
  • antimicrobial stewardship

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Published Papers (3 papers)

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Research

18 pages, 1701 KB  
Article
ISApl4, a New IS1595 Family Insertion Sequence Forming a Novel Pseudo-Compound Transposon That Confers Antimicrobial Multidrug Resistance in Actinobacillus pleuropneumoniae
by Janine T. Bossé, Yanwen Li, Marc Stegger, Liza Miriam Cohen, Øystein Angen, Søren Overballe-Petersen, Dennis Hanke, Stefan Schwarz, Paul R. Langford and Henrike Krüger-Haker
Antibiotics 2025, 14(10), 1021; https://doi.org/10.3390/antibiotics14101021 - 14 Oct 2025
Viewed by 439
Abstract
Background/Objectives: Actinobacillus pleuropneumoniae is an important respiratory tract pathogen of swine worldwide. Insertion sequences (ISs) play a major role in the transfer of antimicrobial resistance (AMR) among various porcine respiratory tract pathogens. In this study, three A. pleuropneumoniae genomes were investigated for the [...] Read more.
Background/Objectives: Actinobacillus pleuropneumoniae is an important respiratory tract pathogen of swine worldwide. Insertion sequences (ISs) play a major role in the transfer of antimicrobial resistance (AMR) among various porcine respiratory tract pathogens. In this study, three A. pleuropneumoniae genomes were investigated for the presence of a novel IS. Methods: Analysis of the draft genomes of three A. pleuropneumoniae serovar 8 isolates (AP_1, AP_120, AP_123) suggested the presence of a novel IS. A closed whole-genome sequence was generated for strain AP_123 by hybrid assembly of Oxford Nanopore MinION long-reads and Illumina MiSeq short-reads, followed by sequence analysis using standard online tools. Transfer was tested by natural transformation. Antimicrobial susceptibility testing was conducted by broth microdilution following Clinical and Laboratory Standards Institute standards. Results: A novel IS, designated ISApl4, was detected in all three genomes. ISApl4 is 712 bp in size and has a transposase gene (tnp) of 654 bp. Moreover, it has perfect terminal 14-bp inverted repeats and produces 8-bp direct repeats at its integration site. This IS was found in 39 copies in the AP_123 genome, two of which formed the 5,765-bp pseudo-compound transposon Tn7560. This transposon carries four AMR genes: sul2 (sulfonamide resistance), strA-strB (streptomycin resistance), and tet(Y) (tetracycline resistance). RT-PCR confirmed tnp gene expression and horizontal transfer of Tn7560 into A. pleuropneumoniae MIDG2331. Conclusions: This study identified the novel ISApl4 in porcine A. pleuropneumoniae and its association with the novel pseudo-compound transposon Tn7560, which proved to be an active element capable of disseminating multidrug resistance amongst A. pleuropneumoniae. Full article
(This article belongs to the Special Issue Antibiotic Therapy in Respiratory Tract Infections (RTIs))
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26 pages, 748 KB  
Article
Beyond Culture: Real-Time PCR Performance in Detecting Causative Pathogens and Key Antibiotic Resistance Genes in Hospital-Acquired Pneumonia
by Lana Hani Abu Khadija, Shatha M. Alomari, Ahmad R. Alsayed, Heba A. Khader, Andi Dian Permana, Luai Z. Hasoun, Manar Saleh Zraikat, Walaa Ashran and Malek Zihlif
Antibiotics 2025, 14(9), 937; https://doi.org/10.3390/antibiotics14090937 - 17 Sep 2025
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Abstract
Introduction: The rise in hospital-acquired pneumonia (HAP) due to antibiotic-resistant bacteria is increasing morbidity, mortality, and inappropriate empirical antibiotic use. This prospective research aimed to evaluate the performance of a real-time polymerase chain reaction (PCR) assay for detecting causative microorganisms and antibiotic-resistance genes [...] Read more.
Introduction: The rise in hospital-acquired pneumonia (HAP) due to antibiotic-resistant bacteria is increasing morbidity, mortality, and inappropriate empirical antibiotic use. This prospective research aimed to evaluate the performance of a real-time polymerase chain reaction (PCR) assay for detecting causative microorganisms and antibiotic-resistance genes from respiratory specimens compared to traditional methods. Additionally, we aimed to determine the molecular epidemiology of antibiotic resistance genes among HAP patients at The University of Jordan hospital. Methods: Lower respiratory tract samples were collected from HAP patients, including those with ventilator-associated pneumonia (VAP), between May 2024 and October 2024. Clinical data from the medical files were used to collect and analyze demographic and clinical information, including clinical outcomes. Real-time PCR was run to detect causative microbes and antibiotic resistance genes. Results: Among 83 HAP patients (median age 63, 61.45% male), 48.15% died. Culture identified Klebsiella (25.53%), Acinetobacter (22.34%), and Candida (24.47%) as the most common pathogens, while qPCR showed higher detection rates, including for A. baumannii (62.20%, p = 0.02) and K. pneumoniae (45.12%, p < 0.001). Carbapenem resistance was high; A. baumannii showed 100% resistance to most antibiotics except colistin (92.31%). The resistance genes ndm (60%) and oxa-48 (58.46%) were frequently detected and significantly associated with phenotypic resistance (p < 0.001). The qPCR identified resistance genes in all carbapenem-resistant cases. No gene significantly predicted mortality. Conclusions: Real-time PCR diagnostic technique combined with epidemiology of antibiotic resistance genes data may be a rapid and effective tool to improve HAP management. Large, multicenter studies are needed in the future to validate the performance of real-time PCR in HAP diagnosis, and appropriate management is also required. Full article
(This article belongs to the Special Issue Antibiotic Therapy in Respiratory Tract Infections (RTIs))
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10 pages, 351 KB  
Article
Role of Antipseudomonal Antibiotics in Older Patients with Aspiration Pneumonia: A Nationwide Database Study in Japan
by Ryohei Kudoh, Daisuke Yoneoka, Akihiko Hagiwara, Hisayuki Shuto, Shota Omori, Kiyohide Fushimi and Kosaku Komiya
Antibiotics 2025, 14(8), 743; https://doi.org/10.3390/antibiotics14080743 - 24 Jul 2025
Viewed by 1214
Abstract
Background: Aspiration pneumonia is increasingly recognized as a fatal pulmonary disease among older people. Although antipseudomonal antibiotics are commonly used in clinical practice, their efficacy in this population remains uncertain. Methods: Nationwide data collected from patients aged ≥65 years who were [...] Read more.
Background: Aspiration pneumonia is increasingly recognized as a fatal pulmonary disease among older people. Although antipseudomonal antibiotics are commonly used in clinical practice, their efficacy in this population remains uncertain. Methods: Nationwide data collected from patients aged ≥65 years who were hospitalized due to aspiration pneumonia from January 2018 to December 2018 were analyzed. The in-hospital mortality between patients who received antipseudomonal antibiotics within 3 days of hospital admission and those who did not were compared. A logistic regression analysis was performed to assess the effect of antipseudomonal antibiotics on in-hospital mortality after adjusting for potential prognostic confounders. Results: This study included 46,980 patients, and 13,340 (28.4%) patients received antipseudomonal antibiotics. In total, 7011 (14.9%) patients died during hospitalization. Advanced age, male sex, a lower body mass index, decreased Barthel Index, impaired consciousness, interstitial pneumonia, malignancy, renal failure, and use of immunosuppressive agents were significantly associated with increased in-hospital mortality. After adjusting for the confounders, the use of antipseudomonal antibiotics was found to be associated with an elevated in-hospital mortality (odds ratio: 1.33; 95% confidence interval: 1.26–1.41; p < 0.001). Conclusions: In this nationwide data analysis of older patients with aspiration pneumonia, early antipseudomonal antibiotic administration did not improve prognosis. Therefore, the routine use of antipseudomonal antibiotics should be avoided in older patients with aspiration pneumonia. Full article
(This article belongs to the Special Issue Antibiotic Therapy in Respiratory Tract Infections (RTIs))
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