Journal of Antimicrobial Agents

Polymyxin B was developed in the 1940s but was infrequently used because of renal toxicity. Since the rise of infections due to multidrug resistant gram-negative organisms, polymyxin B has re-emerged as an important agent. However, its toxicity is still not fully elucidated. In this report, we describe two cases of multiple hypotensive events occurring after polymyxin B administration. Management strategies, such as slowing the infusion rate and administering diphenhydramine, did not mitigate the hypotension. We also describe relatively high polymyxin levels correlated with this effect in one of these cases.

The incidence and mortality rates of severe infections are still very high. Moreover, the growing threat of bacterial resistance and the progressive reduction of research into new antibiotics, overshadows the future of the fight against infections. We need to preserve the effectiveness of available antibiotics. This can only be achieved if we minimize the development of bacterial resistance. We have sufficient evidence to show that reducing the duration of antibiotic treatment can minimize the potential development of bacterial resistance, without worsening the prognosis of infections. So, we think that the proposal to shorten the antibiotic treatment should become a key element of our antibiotic stewardship programs.

Inhaled antibiotics have become a mainstay of cystic fibrosis (CF) therapy by providing high drug concentrations locally in the lung while minimizing systemic exposure and thus the potential for side effects. In CF, inhaled antibiotics decrease the rate of decline of lung function, improve the quality of life, and reduce the frequency of exacerbations and hospital admissions. However, the burden of therapy remains high in CF. There is an opportunity for more convenient and effective inhaled antibiotics to reduce the disease burden in CF. In contrast, despite the unmet medical need, no inhaled antibiotics are approved for lung infections in a number of other diseases including non-CF bronchiectasis, COPD, melioidosis, pneumonic plague, anthrax, Qfever, tularemia and patients with other infections including non-tuberculous mycobacteria. This review discusses the progress towards achieving that goal in those indications. Additionally, the approved inhaled antibiotics in CF are only available as a fixed dose that is inhaled twice or thrice daily. There is a limited opportunity to personalize therapy to the patient. This review envisions a future scenario where the treatment of lung infections can be optimized to the specific needs of each individual based on the attributes of their infectious agents.

Post surgical wound healing is delayed and build intricacies in many patients because of clinical fomites. Vital instruments such as catheters and surgical blades are sterilized and used with immense care by the physicians. In spite of this due to low doubling time of the microbial pathogen multiplication and colonization on the instruments is inevitable, especially in longer surgical procedures, which still remains as a challenge for the clinicians and pathologists across the world. This study regarded isolation of anti-bacterial compound from beneficial bacteria and coating the purified compound on catheters and surgical blades by successive ionic layer adsorption and reaction method to prevent the surface contamination of clinical bacterial pathogen viz., Escherichia coli. After multiple modifications optimal precursor and required timing for coating was achieved and the coated tools provided antisurface colonization property. The compound was found to have no adverse drug reaction with higher affinity human protein receptors.

Microbial infectious diseases continue to be one of the greatest health problems worldwide, afflicting millions of people annually. Due to the diminutive arsenal of efficient antimicrobial agents and the frequent appearance of resistance to the drugs in current use, which consequently reduce the means to treat infected patients, there is a very urgent and continuous need to develop new chemotherapeutic drugs. This paper presents a personal opinion on this theme and some beneficial examples obtained and published by my research group along the last five years.