Currently available antimicrobial agents and their potential for use as monotherapy

Area of Science:

• Microbiology
• Infectious Diseases
• Pharmacology

Background:

• Infectious diseases cause over ten million deaths annually, with antibacterial resistance posing a significant public health challenge.
• Bacteria develop resistance to antibiotics, while pharmaceutical development of new agents declines, creating a treatment dilemma.
• Current antibacterial treatments often lead to more problems than solutions due to resistance and limited drug development.

Purpose of the Study:

• To review current trends in antibacterial drug development.
• To advocate for the judicious use of antibacterial agents.
• To describe a context supporting monotherapy with newer agents.

Main Methods:

• Review of current trends in antibacterial drug development.
• Analysis of the challenges posed by bacterial adaptation and resistance.
• Exploration of antimicrobial stewardship strategies.

Main Results:

• The development of new antibacterial agents is not keeping pace with bacterial resistance.
• Combination therapy can lead to higher total antibiotic exposure compared to monotherapy.
• Limited antibiotic exposure is a key principle for effective antimicrobial stewardship.

Conclusions:

• Adherence to monotherapy, when feasible, is a prudent approach to antimicrobial stewardship.
• Judicious use of antibacterial agents, minimizing exposure, is essential to combat resistance.
• A strategic approach to antibacterial drug use is necessary given current development trends.