Cela Eliana M, Urquiza Dolores, Gómez Marisa I, Gonzalez Cintia D
Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires C1425FQB, Argentina.
Cátedra de Inmunología, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires C1113AAD, Argentina.
Antibiotics (Basel). 2023 Sep 22;12(10):1477. doi: 10.3390/antibiotics12101477.
The treatment of skin and soft tissue infections faces several challenges, such as the increased incidence of antibiotic-resistant strains and the fact that the antibiotics available to treat methicillin-resistant present low bioavailability, are not easily metabolized, and cause severe secondary effects. Moreover, besides the susceptibility pattern of the isolates detected in vitro, during patient treatment, the antibiotics may never encounter the bacteria because hides within biofilms or inside eukaryotic cells. In addition, vascular compromise as well as other comorbidities of the patient may impede proper arrival to the skin when the antibiotic is given parenterally. In this manuscript, we revise some of the more promising strategies to improve antibiotic sensitivity, bioavailability, and delivery, including the combination of antibiotics with bactericidal nanomaterials, chemical inhibitors, antisense oligonucleotides, and lytic enzymes, among others. In addition, alternative non-antibiotic-based experimental therapies, including the delivery of antimicrobial peptides, bioactive glass nanoparticles or nanocrystalline cellulose, phototherapies, and hyperthermia, are also reviewed.
皮肤和软组织感染的治疗面临着诸多挑战，例如抗生素耐药菌株的发病率增加，以及用于治疗耐甲氧西林感染的现有抗生素生物利用度低、不易代谢且会引起严重的副作用。此外，除了体外检测到的分离株的药敏模式外，在患者治疗期间，抗生素可能永远无法接触到细菌，因为细菌隐藏在生物膜内或真核细胞内。此外，当通过肠胃外给药时，血管受损以及患者的其他合并症可能会阻碍抗生素正常到达皮肤。在本手稿中，我们回顾了一些更有前景的策略，以提高抗生素的敏感性、生物利用度和递送效果，包括将抗生素与杀菌纳米材料、化学抑制剂、反义寡核苷酸和裂解酶等联合使用。此外，还综述了替代性的非抗生素实验性疗法，包括抗菌肽、生物活性玻璃纳米颗粒或纳米晶纤维素的递送、光疗法和热疗。
