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Antibiotic combination therapy against resistant bacterial infections: synergy, rejuvenation and resistance reduction.

Coates, ARM; Hu, Y; Holt, J; Yey, P (2020) Antibiotic combination therapy against resistant bacterial infections: synergy, rejuvenation and resistance reduction. Expert Rev Anti Infect Ther, 18 (1). pp. 5-15. ISSN 1744-8336 https://doi.org/10.1080/14787210.2020.1705155
SGUL Authors: Coates, Anthony Robert Milnes Hu, Yanmin

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Abstract

Introduction: Anti-Microbial Resistance (AMR) is a pandemic which threatens modern medicine. There is a lack of effective drug treatment due to the slow pace, high cost and low achievable sales prices of new antibiotic monotherapies. A new hope comes in the shape of antibiotic combination therapy, which although used by mother nature, is under-explored and could provide the solution to AMR.Areas covered: We performed a search of Pubmed and Medline using the keywords "combination therapy", "antimicrobial resistance" for articles between 1930 and 2019, as supplemented with other relevant references to our knowledge. We will review the theoretical considerations for combination development and examine the existing and future clinical indications of combination therapies. We will discuss the potential of antibiotic combinations to provide therapeutic synergy, rejuvenating the effectiveness of old antibiotics to which the bacteria had developed resistance previously. We will examine the current thinking and evidence on resistance reduction using combination therapies, with a review on toxicity and drug-drug antagonism.Expert opinion: Antibiotic combination therapy, exploiting synergies, old-drug rejuvenation and resistance reduction could provide the solution to AMR. The number of pharmaceutical companies in this area is likely to expand, bringing promising combinations to the bedside, to save millions of lives worldwide.

Item Type: Article
Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis in Expert Review of Anti-infective Therapy on 17/12/19, available online: http://www.tandfonline.com/10.1080/14787210.2020.1705155.
Keywords: Anti-Microbial Resistance, Antibiotic Combinations, Superbug, Synergy, Anti-Microbial Resistance, Antibiotic Combinations, Superbug, Synergy, 1103 Clinical Sciences, Microbiology
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Expert Rev Anti Infect Ther
ISSN: 1744-8336
Language: eng
Dates:
DateEvent
9 January 2020Published
17 December 2019Published Online
12 December 2019Accepted
Publisher License: Publisher's own licence
Projects:
Project IDFunderFunder ID
UL1TR001BB1National Center for Advancing Translational Scienceshttp://dx.doi.org/10.13039/100006108
PubMed ID: 31847614
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/111566
Publisher's version: https://doi.org/10.1080/14787210.2020.1705155

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