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Quadruple-Checkerboard: A Modification of the Three-Dimensional Checkerboard for Studying Drug Combinations
Published on: July 24, 2021
[Antibiotic resistance and community-acquired infections]
1Dipartimento di Medicina Clinica Specialistica e Sperimentale, Alma Mater Studiorum Università di Bologna, Policlinico S. Orsola-Malpighi, Bologna. manfredi@.med.unibo.it
Abstract:
The selective pressure of extended broad-spectrum antibiotic administration is leading to a progressively growing selection of common gram-positive and gram-negative organisms which show unpredictable in vitro antimicrobial susceptibility levels to current first-line therapeutic choices. This phenomenon is examined from an epidemiological, microbiological, therapeutical, and pharmacoeconomic point of view, focusing our attention on the most common community-acquired infectious diseases interesting upper and lower airways, genito-urinary and gastrointestinal tract, skin and soft tissues. A broad spectrum of variables is responsible for this ever changing scenario, whose solution cannot be entrusted to the development of new compounds, but it first relies on a rational and judicious administration of existing molecules, and an expanded medical and patient interaction aimed at avoiding overprescription of antimicrobial agents.
Insights
Rising antibiotic resistance in common bacteria necessitates careful drug use. Judicious administration of existing antimicrobials and reduced overprescription are key to managing infections.
Area of Science:
- Microbiology and Infectious Diseases
- Pharmacology
- Epidemiology
Background:
- Extended broad-spectrum antibiotic use drives selection of resistant gram-positive and gram-negative organisms.
- Unpredictable in vitro antimicrobial susceptibility challenges current first-line treatments.
Purpose of the Study:
- To examine the growing challenge of antimicrobial resistance from multiple perspectives.
- To identify strategies for managing common community-acquired infections amidst evolving resistance patterns.
Main Methods:
- Epidemiological analysis of resistance trends.
- Microbiological assessment of organism susceptibility.
- Therapeutic and pharmacoeconomic evaluation of treatment strategies.
Main Results:
- Common pathogens exhibit unpredictable susceptibility to existing antibiotics.
- Multiple variables contribute to the changing resistance landscape.
Conclusions:
- New antibiotic development is not the sole solution.
- Rational, judicious use of current antimicrobial agents is crucial.
- Enhanced medical and patient interaction to prevent overprescription is essential.
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