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Polymyxins are a type of antibiotics that target Gram-negative bacterial infections and have traditionally been used as a last resort to treat serious infections such as those caused by Gram-negative 'superbugs' Klebsiella pneumoniae, P. Resistance to polymyxins is not common, but in late 2015 the first transferable resistance gene to colistin (polymyxin E) was discovered (plasmid-borne mcr-1 gene).This caused significant concerns, as once resistance to polymyxins is established, often no other treatments are available.
Another interesting combination that has shown promise against methicillin-resistant Staphylococcus aureus (MRSA), according to Schneider and co-authors, is combining the antibiotics ampicillin or oxacillin with berberine.
Berberine is extracted from the roots, stems and bark of plants such as barberry.
"Even better if the test could say what type of bacteria, and what types of antibiotics it is resistant to.
You could then treat an infection immediately with the appropriate antibiotic, rather than the trial and error method now used.
While there is no doubting the size of the problem facing scientists, healthcare professionals and the pharmaceutical industry, there are innovative ways we can target antibiotic resistance in the short term, which are discussed in three articles published in Essays in Biochemistry.
With only a few antibiotics in development and a long drug development process (often 10-15 years), there is concern that what is being done to combat antibiotic resistance may be 'too little, too late'.This drug had been developed as an antimicrobial in the 1970s, but only reached pre-clinical development.In addition to the above, researchers are looking for new, untested sources of antimicrobial activity to try and develop new drugs.These Gram-negative bacteria are considered the most critical priority in the list of the 12 families of bacteria that pose the greatest threat to human health that was just released by the World Health Organization.The reasons for the high levels of antimicrobial resistance observed in these critical Gram-negative organisms are explained in another paper in the same issue written by the Guest Editor of the journal, Dr Rietie Venter, University of South Australia, Adelaide, and colleagues.Repurposing drugs originally developed and approved for other uses has also had some success.In 2005, the Drugs for Neglected Diseases initiative identified fexinadole as a potential treatment for sleeping sickness and it is now undergoing a Phase III trial.For example, the authors recently created a modified version of the antibiotic vancomycin to increase its potency and reduce its toxic side effects. In the 1950s and 60s many potential antibiotic drugs were described in the scientific literature, but due to so many choices being available at the time, only some were developed for human use.An example of this is octapeptins, which are newly rediscovered antibiotics that are now being developed to combat Gram-negative 'superbugs'.Using this novel approach, an FDA-approved non-antibiotic drug is combined with a specific antibiotic that enables it to breach the outer membrane barrier and so restore the activity of an antibiotic.The Monash University authors discuss how combining antibiotics with other non-antibiotic drugs or compounds can boost their effectiveness against Gram-negative 'superbugs'.