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Corneal Disorders
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
Darren S. J. Ting, Rashmi Deshmukh, Daniel S. W. Ting, Marcus Ang
Several large-scale IK studies have also helped identify the emerging issue of antimicrobial resistance (AMR) against the common antimicrobial agents used for IK.82,83 Broad-spectrum topical antimicrobial therapy serves as the current gold standard for treating IK, and AMR has been shown to negatively affect the outcome and healing time of IK.84 In the Antibiotic Resistance Among Ocular Microorganisms (ARMOR) trial with data from 6091 ocular isolates, Asbell et al.82 observed that 35% and 49% of the Staphylococcus aureus and coagulase-negative staphylococci were methicillin-resistant. Moreover, these microorganisms were often associated with multidrug resistance. In contrast, the Nottingham Infectious Keratitis Study, UK, demonstrated a low rate (<5%) of AMR against the commonly employed antibiotic regimens used for IK, namely fluoroquinolone monotherapy and cephalosporin–aminoglycoside dual therapy.35 These findings highlight the geographical variations in AMR for IK and the importance of up-to-date examination in each region.
Antibody-Based Therapies
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
Most duocarmycin-type compounds have in vitro potency in the low picomolar range which makes them ideally suitable for maximizing the cell-killing potency of antibodies to which they are attached. Another important benefit is that, unlike other drug classes, the duocarmycins can be effective against tumor cells that are multidrug resistant. For example, potent cytotoxicity has been demonstrated in cells that express the P-glycoprotein (P-gp) efflux pump. Multidrug resistance presents a significant problem in the clinical setting, and agents that are less susceptible to these mechanisms are highly sought after.
Laboratory Detection of β-Lactam Resistance in Enterobacterales
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Routine antimicrobial susceptibility testing may be unreliable in detecting antimicrobial resistance mechanisms. This can lead to treatment failure, increased mortality and emergence and spread of multidrug resistance. Hospital-acquired infections are most commonly caused by Gram-negative rods. β-lactam agents are the mainstay of treatment of Gram-negative infections. However, multidrug resistance is increasingly occurring worldwide. Knowledge of the clinically most important β-lactam resistance mechanisms and extra tests to detect them enhances and guides antimicrobial stewardship and infection prevention and control. It is therefore worthwhile to consider the following.
Modulating multidrug resistance to drug-based antitumor therapies through NF-κB signaling pathway: mechanisms and perspectives
Published in Expert Opinion on Therapeutic Targets, 2023
Dapeng Wu, Sai Tian, Wenjing Zhu
Various drug-based therapeutic strategies are currently utilized in antitumor treatment, including chemotherapy, immunotherapy, endocrine and targeted therapy [2]. Multidrug resistance (MDR) which accounts for a poor response to therapeutic drugs, has become one of the main hurdles that challenge effective cancer treatment. Owing to primary or acquired drug resistance, patients often show low reactions to the tumor therapy, or respond well initially but experience later cancer relapse and progression. Multidrug resistance was thought to arise as a consequence of intrinsic genetic modifications, including enhancement of drug efflux pumps, apoptosis evasion, activation of detoxifying enzymes, signaling pathway switching, increased DNA repair, and cell metabolic reprogramming [3]. Over the past decades, scientists have been searching for methods to overcome drug resistance. For instance, much effort has been made to target the ATP-binding cassette (ABC) transporters, both genetically and pharmacologically [2]. However, both antitumor compounds and genetic tools suffer problems of poor bioavailability and degradation by nucleases respectively, calling for more feasible strategies to overcome multidrug resistance [4]. Although many studies have explored how resistance arises and which signaling pathways are involved in the process, the mechanisms of multidrug resistance are still not clearly elucidated.
Synthesis of silver nanoparticles using Ziziphus nummularia leaf extract and evaluation of their antimicrobial, antioxidant, cytotoxic and genotoxic potential (4-in-1 system)
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2021
Hemali Padalia, Sumitra Chanda
The development of multidrug resistance in pathogens is key hazard to public health because of exploitation of drugs, diagnosis and treatment and overconsumption of antibiotics. Silver nanoparticles have been considered as a possible substitute to antibiotics and act as effective antimicrobial agents against a panel of the pathogenic microorganisms that do not produce microbial resistance and present a good bacteriostatic and bactericidal activity. The biosynthesized AgNPs from A. marina seed extract display broad-spectrum antibacterial activity. The AgNPs showed inhibitory activity against a range of pathogenic bacterial species such as Pseudomonas aeruginosa, Escherichia coli, Bacillus subtilis and Staphylococcus aureus [11,33] synthesized AgNPs using marine red algae Gelidium amansii and evaluated their antibacterial potential against B. pumilus, S. aureus, Aeromonas hydrophila, P. aeruginosa and Vibrio parahaemolyticus.
Current treatment options and safety considerations when treating adult-onset Still’s disease
Published in Expert Opinion on Drug Safety, 2020
Giulio Cavalli, Nicola Farina, Corrado Campochiaro, Elena Baldissera, Lorenzo Dagna
Data on the clinical efficacy of IL-18 blockade in AOSD are still limited. Recent studies reported promising results with takedinig α, a recombinant IL-18BP, for the treatment of severe AOSD patients [99]. However, the most conspicuous available information comes from a phase II trial that showed takedinig α was associated with an early clinical and laboratory efficacy, irrespective of the dosage. The median disease duration of the study population was 15 months; 50% of patients were previously treated with a csDMARD in half of cases and with a previous bDMARD in about one-third of patients. Hence, this studied involved patients with long-standing multidrug-resistant disease. Despite these predictors of poor response to treatment, the response rate to takedinig α was almost 50%. Similarly to anakinra, the most frequent adverse reaction to IL-18 inhibition was injection site reaction [100].