Lai Christopher K C, Ng Rita W Y, Leung Sharon S Y, Hui Mamie, Ip Margaret
Department of Microbiology, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong Special Administrative Region.
School of Pharmacy, The Chinese University of Hong Kong, New Territories, Hong Kong Special Administrative Region.
Adv Drug Deliv Rev. 2022 Feb;181:114078. doi: 10.1016/j.addr.2021.114078. Epub 2021 Dec 9.
Antimicrobial resistance is a normal evolutionary process for microorganisms. Antibiotics exerted accelerated selective pressure that hasten bacterial resistance through mutation, and acquisition external genes. These genes often carry multiple antibiotic resistant determinants allowing the recipient microbe an instant "super-bug" status. The extent of Antimicrobial Resistance (AMR) has reached a level of global crisis, existing antimicrobials are no long effective in treating infections caused by AMR pathogens. The great majority of clinically available antimicrobial agents are administered through oral and intra-venous routes. Overcoming antibacterial resistance by novel drug delivery approach offered new hopes, particularly in the treatment of AMR pathogens in sites less assessible through systemic circulation such as the lung and skin. In the current review, we will revisit the mechanism and incidence of important AMR pathogens. Finally, we will discuss novel drug delivery approaches including novel local antibiotic delivery systems, hybrid antibiotics, and nanoparticle-based antibiotic delivery systems.
抗菌药物耐药性是微生物的一种正常进化过程。抗生素施加了加速的选择压力，通过突变和获取外源基因加速细菌耐药性。这些基因通常携带多个抗生素耐药决定簇，使受体微生物立即获得“超级细菌”状态。抗菌药物耐药性（AMR）的程度已达到全球危机水平，现有的抗菌药物对治疗由AMR病原体引起的感染不再有效。绝大多数临床可用的抗菌剂通过口服和静脉途径给药。通过新型药物递送方法克服抗菌耐药性带来了新的希望，特别是在治疗肺部和皮肤等通过全身循环难以到达部位的AMR病原体方面。在当前的综述中，我们将重新审视重要AMR病原体的机制和发生率。最后，我们将讨论新型药物递送方法，包括新型局部抗生素递送系统、混合抗生素和基于纳米颗粒的抗生素递送系统。
