Journal
ADVANCED DRUG DELIVERY REVIEWS
Volume 78, Issue -, Pages 14-27Publisher
ELSEVIER
DOI: 10.1016/j.addr.2014.10.027
Keywords
Antibiotics; Antimicrobial polymers; Biofilm; Quorum sensing; Combination therapy; Nanoparticle delivery
Categories
Funding
- Elute Inc.
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With multidrug resistant bacteria on the rise, new antibiotic approaches are required. Although a number of new small molecule antibiotics are currently in the development pipeline with many more in preclinical development, the clinical options and practices for infection control must be expanded. Biologics and non-antibiotic adjuvants offer this opportunity for expansion. Nevertheless, to avoid known mechanisms of resistance, intelligent combination approaches for multiple simultaneous and complimentary therapies must be designed. Combination approaches should extend beyond biologically active molecules to include smart controlled delivery strategies. Infection control must integrate antimicrobial stewardship, new antibiotic molecules, biologic, and delivery strategies into effective combination therapies designed to 1) fight the infection, 2) avoid resistance, and 3) protect the natural microbiome. This review explores these developing strategies in the context of circumventing current mechanisms of resistance. (C) 2014 Elsevier B.V. All rights reserved.
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