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Keywords = irrational antibiotic therapy

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12 pages, 3125 KB  
Article
Polymyxin E-Modified Conjugated Polymer Nanoparticle for Photodynamic and Photothermal Combined Antimicrobial Therapy
by Qi Jiang, Yulu Hu, Huimin Ye, Xinyue Hu, Yue Yang, Minghui Yang, Fang Wang, Mengna Zhang and Lisheng Qian
Molecules 2026, 31(3), 409; https://doi.org/10.3390/molecules31030409 - 25 Jan 2026
Viewed by 220
Abstract
The irrational or excessive use of antibiotics causes the emergence of bacterial resistance, making antibiotics less effective or ineffective. As the number of resistant antibiotics increases, it is crucial to develop new strategies and innovative approaches to potentiate the efficacy of existing antibiotics. [...] Read more.
The irrational or excessive use of antibiotics causes the emergence of bacterial resistance, making antibiotics less effective or ineffective. As the number of resistant antibiotics increases, it is crucial to develop new strategies and innovative approaches to potentiate the efficacy of existing antibiotics. Prior to this, we discovered that some of the traditional antibiotics produce reactive oxygen species (ROS) under specific light exposure. In this paper, we report a multifunctional polymeric nanoparticle (F8IC NPs-PME) that combines targeted and photodynamic–photothermal therapy (PDT-PTT) in one device. The PME on the surface of F8IC enables the selective binding of F8IC NPs-PME to the surface of Gram-negative bacteria. In addition, PME and F8IC can generate ROS and photothermia under near-infrared light excitation, respectively. The results showed that the sterilization efficiency of F8IC NPs-PME at a concentration of 8 μg/mL was as high as 94.7% against kanamycin-resistant E. coli under 808 nm near-infrared light irradiation (0.8 W/cm2, 10 min). This antimicrobial strategy can achieve efficient bacteria killing with a low dosage of antibiotics and opens up a new avenue for fighting bacterial resistance. Full article
(This article belongs to the Section Nanochemistry)
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29 pages, 3654 KB  
Review
A Mechanistic Approach to Replacing Antibiotics with Natural Products in the Treatment of Bacterial Diarrhea
by Mingbang Wei, Huaizhi Liu, Zhefan Hu, Peixiao Wen, Yourong Ye, Yangzom Chamba, Hongliang Zhang and Peng Shang
Biomolecules 2025, 15(7), 1045; https://doi.org/10.3390/biom15071045 - 18 Jul 2025
Cited by 2 | Viewed by 1914
Abstract
Natural products have emerged as potential alternatives to antibiotics in the treatment of bacterial diarrhea, due to their multi-targeting effects, low potential for inducing resistance, and favorable safety profiles. Currently, the search for natural product-based therapies has become an emerging focus in medical [...] Read more.
Natural products have emerged as potential alternatives to antibiotics in the treatment of bacterial diarrhea, due to their multi-targeting effects, low potential for inducing resistance, and favorable safety profiles. Currently, the search for natural product-based therapies has become an emerging focus in medical research. This growing interest is driven by the increasing awareness that the widespread and irrational use of antibiotics has contributed to the alarming rise in antibiotic-resistant bacterial strains, which in turn diminishes the efficacy of conventional drugs. Among these concerns, the limitations of antibiotics in managing bacterial diarrhea and the potential mechanisms by which natural products exert therapeutic effects are the main focus of this paper. Natural products, containing a wide array of bioactive compounds, can not only directly inhibit the growth of pathogenic bacteria, disrupt bacterial membrane synthesis, and reduce toxin production, but also modulate inflammatory responses, enhance immune function, repair intestinal barriers, and restore gut microbial ecology—highlighting their systemic and multi-targeted therapeutic potential. Therefore, this paper will elaborate on how natural products combat bacterial diarrhea from three aspects: the pathogen and pathogenesis of bacterial diarrhea, natural product-based therapeutic studies, and the underlying mechanisms of action, thereby proposing natural products as viable alternatives to antibiotics. Full article
(This article belongs to the Section Natural and Bio-derived Molecules)
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13 pages, 914 KB  
Article
The Impact of Cefuroxime Susceptibility on Aeromonas Necrotizing Fasciitis Outcomes
by Tsung-Yu Huang, Shu-Fang Kuo, Yao-Hung Tsai, Jiun-Liang Chen, Kuo-Ti Peng, Yao-Kuang Huang, Chien-Hui Hung, Yen-Yao Li, Hsing-Jung Li, Cheng-Ting Hsiao and Wei-Hsiu Hsu
Microorganisms 2023, 11(11), 2776; https://doi.org/10.3390/microorganisms11112776 - 15 Nov 2023
Cited by 4 | Viewed by 2156
Abstract
Despite aggressive antibiotic therapy and surgical debridement, Aeromonas necrotizing fasciitis (NF) can lead to high amputation and mortality rates. Our study compares the different antibiotic minimum inhibitory concentrations (MICs) via Epsilometer tests (E-tests) between non-survivors and survivors of Aeromonas NF of limbs. A [...] Read more.
Despite aggressive antibiotic therapy and surgical debridement, Aeromonas necrotizing fasciitis (NF) can lead to high amputation and mortality rates. Our study compares the different antibiotic minimum inhibitory concentrations (MICs) via Epsilometer tests (E-tests) between non-survivors and survivors of Aeromonas NF of limbs. A prospective review of 16 patients with Aeromonas NF was conducted for 3.5 years in a tertiary coastal hospital. E-tests were conducted for 15 antimicrobial agents to determine the MIC value for Aeromonas species. These patients were divided into non-survival and survival groups. The clinical outcomes, demographics, comorbidities, presenting signs and symptoms, laboratory findings, and microbiological results between the two periods were compared. A total of four patients died, whereas 12 survived, resulting in a 25% mortality rate. A higher proportion of bloodstream infections (100% vs. 41.7%; p = 0.042), monomicrobial infections (100% vs. 33.3%; p = 0.021), shock (100% vs. 33.3%; p = 0.021), serous bullae (50% vs. 0%; p = 0.009), liver cirrhosis (100% vs. 25%; p = 0.009), chronic kidney disease (100% vs. 33.3%; p = 0.021), lower susceptibility to cefuroxime (25% vs. 83.3%; p = 0.028), and ineffective antibiotic prescriptions (75% vs. 16.7%; p = 0.029) was observed in non-survivors. Aeromonas NF is an extremely rare skin and soft-tissue infection that is associated with high mortality, bacteremia, antibiotic resistance, and polymicrobial infection. Therefore, antibiotic regimen selection is rendered very challenging. To improve clinical outcomes and irrational antimicrobial usage, experienced microbiologists can help physicians identify specific pathogens and test MIC. Full article
(This article belongs to the Special Issue Aeromonas and Plesiomonas)
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22 pages, 4983 KB  
Review
Extended-Spectrum β-Lactamases (ESBL): Challenges and Opportunities
by Asmaul Husna, Md. Masudur Rahman, A. T. M. Badruzzaman, Mahmudul Hasan Sikder, Mohammad Rafiqul Islam, Md. Tanvir Rahman, Jahangir Alam and Hossam M. Ashour
Biomedicines 2023, 11(11), 2937; https://doi.org/10.3390/biomedicines11112937 - 30 Oct 2023
Cited by 218 | Viewed by 33332
Abstract
The rise of antimicrobial resistance, particularly from extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-E), poses a significant global health challenge as it frequently causes the failure of empirical antibiotic therapy, leading to morbidity and mortality. The E. coli- and K. pneumoniae-derived CTX-M genotype [...] Read more.
The rise of antimicrobial resistance, particularly from extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-E), poses a significant global health challenge as it frequently causes the failure of empirical antibiotic therapy, leading to morbidity and mortality. The E. coli- and K. pneumoniae-derived CTX-M genotype is one of the major types of ESBL. Mobile genetic elements (MGEs) are involved in spreading ESBL genes among the bacterial population. Due to the rapidly evolving nature of ESBL-E, there is a lack of specific standard examination methods. Carbapenem has been considered the drug of first choice against ESBL-E. However, carbapenem-sparing strategies and alternative treatment options are needed due to the emergence of carbapenem resistance. In South Asian countries, the irrational use of antibiotics might have played a significant role in aggravating the problem of ESBL-induced AMR. Superbugs showing resistance to last-resort antibiotics carbapenem and colistin have been reported in South Asian regions, indicating a future bleak picture if no urgent action is taken. To counteract the crisis, we need rapid diagnostic tools along with efficient treatment options. Detailed studies on ESBL and the implementation of the One Health approach including systematic surveillance across the public and animal health sectors are strongly recommended. This review provides an overview of the background, associated risk factors, transmission, and therapy of ESBL with a focus on the current situation and future threat in the developing countries of the South Asian region and beyond. Full article
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15 pages, 3820 KB  
Article
Changes in Antibiotic Resistance of Acinetobacter baumannii and Pseudomonas aeruginosa Clinical Isolates in a Multi-Profile Hospital in Years 2017–2022 in Wroclaw, Poland
by Beata Mączyńska, Agnieszka Jama-Kmiecik, Jolanta Sarowska, Krystyna Woronowicz, Irena Choroszy-Król, Daniel Piątek and Magdalena Frej-Mądrzak
J. Clin. Med. 2023, 12(15), 5020; https://doi.org/10.3390/jcm12155020 - 30 Jul 2023
Cited by 14 | Viewed by 3751
Abstract
In recent years, we have witnessed increasing drug resistance among bacteria, which is associated with the use and availability of an increasing number of broad-spectrum antimicrobials, as well as with their irrational and excessive use. The present study aims to analyze changes in [...] Read more.
In recent years, we have witnessed increasing drug resistance among bacteria, which is associated with the use and availability of an increasing number of broad-spectrum antimicrobials, as well as with their irrational and excessive use. The present study aims to analyze changes in the drug resistance of Gram-negative Pseudomonas aeruginosa and Acinetobacter baumannii, isolated from infections in a multi-profile hospital over a five-year period (from 2017 to 2022). Among the practical results of the evaluation of these data will be the possibility to determine changes in susceptibility to the antibiotics used in the hospital. This, in turn, will help propose new therapeutic options, especially for empirical therapy, which is essential in severe infections. Analysis of the use of different antibiotic groups has made it possible to identify the causes of increasing resistance in the analyzed Gram-negative bacilli. The highest antibiotic use was observed in the hospital between 2020 and 2022, most probably due to the COVID-19 pandemic and the higher number of patients in severe condition requiring hospitalization. Unfortunately, during the period analyzed, the number of multi-resistant strains of A. baumannii was successively increasing; this seems to be related to the increased use, especially during the pandemic period, of broad-spectrum antibiotics, mainly penicillins with inhibitors, third-generation cephalosporins and carbapenems. Full article
(This article belongs to the Section Infectious Diseases)
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25 pages, 8590 KB  
Article
Evolution of Antibiotic Resistance in Escherichia coli and Klebsiella pneumoniae Clinical Isolates in a Multi-Profile Hospital over 5 Years (2017–2021)
by Beata Mączyńska, Magdalena Frej-Mądrzak, Jolanta Sarowska, Krystyna Woronowicz, Irena Choroszy-Król and Agnieszka Jama-Kmiecik
J. Clin. Med. 2023, 12(6), 2414; https://doi.org/10.3390/jcm12062414 - 21 Mar 2023
Cited by 22 | Viewed by 4631
Abstract
In recent years, we have witnessed a growing drug resistance among bacteria, which is associated with the use and availability of an increasing number of broad-spectrum antimicrobial agents, as well as with their irrational and excessive use. The present study aims to analyze [...] Read more.
In recent years, we have witnessed a growing drug resistance among bacteria, which is associated with the use and availability of an increasing number of broad-spectrum antimicrobial agents, as well as with their irrational and excessive use. The present study aims to analyze changes in the drug resistance of Gram-negative Enterobacterales: Escherichia coli and Klebsiella pneumoniae, isolated from infections in a multi-profile hospital over five years (from 2017 to 2021). Among the practical outcomes of the evaluation of these data will be the possibility of determining changes in susceptibility to the antibiotics used in the hospital. In turn, this will help propose new therapeutic options, especially for empirical therapy that is necessary in severe infections. The analysis of the use of individual groups of antibiotics allowed for identification of the causes of the increasing resistance of Gram-negative bacilli. The highest number of infections whose etiological agent was K. pneumoniae ESBL(+) and E. coli ESBL(+) was observed in 2018. In the analyzed five-year period, the number of multi-resistant (MDR) K. pneumoniae strains increased successively, which seems to be related to the growing use, especially in the pandemic period, of broad-spectrum antibiotics, mainly penicillins with inhibitors, third-generation cephalosporins, and carbapenems. Full article
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21 pages, 1128 KB  
Review
Therapeutic Potential of Flavonoids and Tannins in Management of Oral Infectious Diseases—A Review
by Ján Kováč, Lívia Slobodníková, Eva Trajčíková, Katarína Rendeková, Pavel Mučaji, Alice Sychrová and Silvia Bittner Fialová
Molecules 2023, 28(1), 158; https://doi.org/10.3390/molecules28010158 - 24 Dec 2022
Cited by 56 | Viewed by 11511
Abstract
Medicinal plants are rich sources of valuable molecules with various profitable biological effects, including antimicrobial activity. The advantages of herbal products are their effectiveness, relative safety based on research or extended traditional use, and accessibility without prescription. Extensive and irrational usage of antibiotics [...] Read more.
Medicinal plants are rich sources of valuable molecules with various profitable biological effects, including antimicrobial activity. The advantages of herbal products are their effectiveness, relative safety based on research or extended traditional use, and accessibility without prescription. Extensive and irrational usage of antibiotics since their discovery in 1928 has led to the increasing expiration of their effectiveness due to antibacterial resistance. Now, medical research is facing a big and challenging mission to find effective and safe antimicrobial therapies to replace inactive drugs. Over the years, one of the research fields that remained the most available is the area of natural products: medicinal plants and their metabolites, which could serve as active substances to fight against microbes or be considered as models in drug design. This review presents selected flavonoids (such as apigenin, quercetin, kaempferol, kurarinone, and morin) and tannins (including oligomeric proanthocyanidins, gallotannins, ellagitannins, catechins, and epigallocatechin gallate), but also medicinal plants rich in these compounds as potential therapeutic agents in oral infectious diseases based on traditional usages such as Agrimonia eupatoria L., Hamamelis virginiana L., Matricaria chamomilla L., Vaccinium myrtillus L., Quercus robur L., Rosa gallica L., Rubus idaeus L., or Potentilla erecta (L.). Some of the presented compounds and extracts are already successfully used to maintain oral health, as the main or additive ingredient of toothpastes or mouthwashes. Others are promising for further research or future applications. Full article
(This article belongs to the Special Issue The Natural Products in Topical Infections and Wound Healing)
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16 pages, 2893 KB  
Article
Exploring Knowledge of Antibiotic Use, Resistance, and Stewardship Programs among Pharmacy Technicians Serving in Ambulatory Care Settings in Pakistan and the Implications
by Zia Ul Mustafa, Marriam Nazir, Hafiza Kiran Majeed, Muhammad Salman, Khezar Hayat, Amer Hayat Khan, Johanna C. Meyer and Brian Godman
Antibiotics 2022, 11(7), 921; https://doi.org/10.3390/antibiotics11070921 - 8 Jul 2022
Cited by 15 | Viewed by 3734
Abstract
Antimicrobial resistance (AMR) is a leading global health threat, increasing morbidity, mortality, and costs, with excessive and irrational use of antimicrobials contributing to the development of AMR. Consequently, the aims of this study were to evaluate the understanding of antibiotic use, AMR, and [...] Read more.
Antimicrobial resistance (AMR) is a leading global health threat, increasing morbidity, mortality, and costs, with excessive and irrational use of antimicrobials contributing to the development of AMR. Consequently, the aims of this study were to evaluate the understanding of antibiotic use, AMR, and antimicrobial stewardship programs (ASPs) among pharmacy technicians serving in ambulatory healthcare settings in Pakistan. A cross-sectional survey was conducted among pharmacy technicians serving in 144 ambulatory care settings in seven districts of Punjab province using a validated questionnaire. Overall, 376 technicians completed the survey (85.8% response rate). The majority were men (89.1%), aged 25–35 years (45.1%), serving in emergency departments (43.9%) and filling 31–60 prescriptions per day (37.5%). Most (79.5%) knew that antibiotics were one of the most frequently prescribed drug classes, while 59.8% believed antibiotics for common colds did not speed up recovery. Inadequate duration (59.6%) and inadequate dosages (57.7%) of antibiotic therapy were reported as the leading causes of AMR. Terms including ‘superbugs’, ‘multidrug resistance’, and ‘extensively drug resistance’ were known to 42.0%, 25.3%, and 20.7% of participants, respectively; however, <10% knew about ASPs, including their core elements and purpose. Our study revealed that pharmacy technicians have adequate awareness of antibiotic use but are currently unaware of AMR and ASPs, which is a concern. Full article
(This article belongs to the Section Antibiotics Use and Antimicrobial Stewardship)
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16 pages, 2153 KB  
Article
Fecal Microbiota Analysis in Cats with Intestinal Dysbiosis of Varying Severity
by Nikolay Bugrov, Pavel Rudenko, Vladimir Lutsay, Regina Gurina, Andrey Zharov, Nadiya Khairova, Maria Molchanova, Elena Krotova, Marina Shopinskaya, Marina Bolshakova and Irina Popova
Pathogens 2022, 11(2), 234; https://doi.org/10.3390/pathogens11020234 - 10 Feb 2022
Cited by 19 | Viewed by 5457
Abstract
Recent studies have shown that the gut microbiota plays an important role in the pathogenesis of gastrointestinal diseases in various animal species. There are only limited data on the microbiome in cats with varying grades of dysbiosis. The purpose of the study was [...] Read more.
Recent studies have shown that the gut microbiota plays an important role in the pathogenesis of gastrointestinal diseases in various animal species. There are only limited data on the microbiome in cats with varying grades of dysbiosis. The purpose of the study was a detailed analysis of the quantitative and qualitative fecal microbiota spectrum in cats with intestinal dysbiosis of varying severity. The data obtained indicate that, depending on the dysbiosis severity in cats, the intestinal microbiome landscape changes significantly. It has been established that, depending on the dysbiosis severity, there is a shift in the balance between the Gram-positive and Gram-negative bacterial pools and in the nature of the isolation of specific bacteria forms, in the amount of obligate microbiota isolation, as well as individual facultative strains. When analyzing the serotyping of E. coli cultures isolated at various grades of intestinal dysbiosis severity, differences were found both in the isolation amount of various serotypes from one animal and in the prevalence of certain serotypes for each disease severity. A retrospective analysis of the fecal microbiota sensitivity in cats with dysbiosis to antibacterial drugs showed that, depending on the disease severity, the number of isolates sensitive to antibiotics increases significantly. Full article
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23 pages, 378 KB  
Review
Antibiotics and the Nervous System—Which Face of Antibiotic Therapy Is Real, Dr. Jekyll (Neurotoxicity) or Mr. Hyde (Neuroprotection)?
by Magdalena Hurkacz, Lukasz Dobrek and Anna Wiela-Hojeńska
Molecules 2021, 26(24), 7456; https://doi.org/10.3390/molecules26247456 - 9 Dec 2021
Cited by 46 | Viewed by 10242
Abstract
Antibiotics as antibacterial drugs have saved many lives, but have also become a victim of their own success. Their widespread abuse reduces their anti-infective effectiveness and causes the development of bacterial resistance. Moreover, irrational antibiotic therapy contributes to gastrointestinal dysbiosis, that increases the [...] Read more.
Antibiotics as antibacterial drugs have saved many lives, but have also become a victim of their own success. Their widespread abuse reduces their anti-infective effectiveness and causes the development of bacterial resistance. Moreover, irrational antibiotic therapy contributes to gastrointestinal dysbiosis, that increases the risk of the development of many diseases, including neurological and psychiatric. One of the potential options for restoring homeostasis is the use of oral antibiotics that are poorly absorbed from the gastrointestinal tract (e.g., rifaximin alfa). Thus, antibiotic therapy may exert neurological or psychiatric adverse drug reactions which are often considered to be overlooked and undervalued issues. Drug-induced neurotoxicity is mostly observed after beta-lactams and quinolones. Penicillin may produce a wide range of neurological dysfunctions, including encephalopathy, behavioral changes, myoclonus or seizures. Their pathomechanism results from the disturbances of gamma-aminobutyric acid-GABA transmission (due to the molecular similarities between the structure of the β-lactam ring and GABA molecule) and impairment of the functioning of benzodiazepine receptors (BZD). However, on the other hand, antibiotics have also been studied for their neuroprotective properties in the treatment of neurodegenerative and neuroinflammatory processes (e.g., Alzheimer’s or Parkinson’s diseases). Antibiotics may, therefore, become promising elements of multi-targeted therapy for these entities. Full article
(This article belongs to the Special Issue Neurotransmitter-Related Molecular Modeling Studies)
12 pages, 555 KB  
Review
Phage Therapy in Livestock and Companion Animals
by Celia Ferriol-González and Pilar Domingo-Calap
Antibiotics 2021, 10(5), 559; https://doi.org/10.3390/antibiotics10050559 - 11 May 2021
Cited by 46 | Viewed by 9622
Abstract
The irrational use of antibiotics has led to a high emergence of multi-drug resistant (MDR) bacteria. The traditional overuse of antibiotics in the animal feed industry plays a crucial role in the emergence of these pathogens that pose both economic and health problems. [...] Read more.
The irrational use of antibiotics has led to a high emergence of multi-drug resistant (MDR) bacteria. The traditional overuse of antibiotics in the animal feed industry plays a crucial role in the emergence of these pathogens that pose both economic and health problems. In addition, antibiotics have also recently experienced an increase to treat companion animal infections, promoting the emergence of MDR bacteria in pets, which can reach humans. Phages have been proposed as an alternative for antibiotics for the treatment of livestock and companion animal infections due to their multiple advantages as adaptative drugs, such as their ability to evolve, to multiply at the site of infections, and their high specificity. Moreover, phage-derived enzymes may also be an interesting approach. However, the lack of regulation for this type of pharmaceutical hinders its potential commercialization. In this review, we summarize the main recent studies on phage therapy in livestock and companion animals, providing an insight into current advances in this area and the future of treatments for bacterial infections. Full article
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