Kucers’ THE USE OF ANTIBIOTICS A Clinical Review of Antibacterial, Antifungal, Antiparasitic, and Antiviral Drugs PDF Ebook
Kucers’ encyclopedic report on the current status of virtually
all antimicrobial agents is testimony to the extraordinary, un-ending progress in dealing with infectious diseases.
Kucers’ THE USE OF ANTIBIOTICS A Clinical Review of Antibacterial, Antifungal, Antiparasitic, and Antiviral Drugs PDF download, with unexplored or incompletely pursued opportunities, there are formidable challenges ahead. The most obvious new challenges and opportunities are antibiotic resistance, expanded pursuit of antiviral agents, the constant emergence of new infectious disease threats, and, possibly, manipulation of the microbiome.
Kucers’ THE USE OF ANTIBIOTICS A Clinical Review of Antibacterial, Antifungal, Antiparasitic, and Antiviral Drugs PDF download advantage of most antimicrobial agents is that they are readily available, relatively inexpensive, usually short
course, and generally well-tolerated. These advantages are
also economic disincentives for new drug development. The result is extensive abuse with progressive increases in resis-tance rates of nearly all pathogens according to Mendelian
laws of survival. Antimicrobial resistance has now reached a crisis stage with warnings for the “post-antibiotic era”.
Kucers’ THE USE OF ANTIBIOTICS A Clinical Review of Antibacterial, Antifungal, Antiparasitic, and Antiviral Drugs PDF download problem was predicted in the 2006 publication Bad Bugs, Need Drugs (Talbot et al., 2006), but the concern was largely ignored by the medical community until it was declared a “crisis” a decade later by the CDC, WHO, and key world leaders, including President Obama (Institute of Medicine [US] Forum on Microbial Threats, 2010; Spellberg et al., 2008).
The response to this crisis has been impressive in terms of new
products for treatment of diverse infections, including those
caused by resistant pathogens. For example, the number of new antibiotics approved by the FDA decreased to only one in the four year period of 2008–2012. This has increased dramatically to 10 new antibiotics in the last 4 years! (Gould and Bal, 2013).
This progress has also included methods to dissuade antibiotic abuse with improved diagnostics, multiple evidence-based guidelines, new infection prevention methods, and new products to help distinguish bacterial vs. non-bacterial infections. In addition, the recent history of anti-infective development has expanded in multiple directions (Carlet et al., 2014)New agents that are recently FDA-approved or in late stage development to improve current care options include those active against resistant Gram-negative bacilli (ceftazidime/avibactam [Mazuski et al., 2016], ceftolozane/tazobactam [Popejoyet al., 2017]), S. aureus (tedizolid, dalbavancin and oritavancin), and C.difficile infection (fidaxomicin, bezlotoxumab, and cadazolid [Bassères et al., 2017]). Furthermore, the pipe-line of additional new anti-bacterial agents to address resistance is robust, including multiple new polymyxins, meropenem/rpx7009, and plazomicin.
Omadacycline is a member of a new class of antibiotics (Aminomethylcyclines) with an extraordinary spectrum analogous to that of tigecycline against many antibiotic resistant bacteria (Pfaller et al., 2017), but despite this promise, it is premature to predict its future role in managing infections.
The unexpected and incredibly successful interventions to prevent and treat HIV infection have led to what is now the remarkable possibility of near-cure for many patients with HIV. Other viral pathogens that were once thought untreatable, but now have effective therapies available, include influenza, CMV, RSV, Herpes simplex, H. zoster, hepatitis B, and hepatitis C. This appears to be an ever-growing area of new drug development—one that is reflected in the hugely expanded antiviral section of this edition of Kucers’. Never-theless, other viral infections have proven more difficult.
For instance, arborviral infections (Zika, dengue, chikagun-gunya, and yellow fever) represent great threats in much of the world, including the US, in part due to climate change (Paules and Fauci, 2017). Although new antiviral agents are being developed, experience suggests that mosquito control and vaccines are likely to be most effective. The same applies to Ebola viral infections that have been so devastating in some regions of Africa and elsewhere.
A unique feature of the infectious disease field is the constant discovery and emergence of new pathogens, each representing a new challenge for detection, treatment, and public health control. Examples in the past 30 years include Staphylococcus toxic shock syndrome, AIDS, West Nile virus, Lyme disease, H5 N1influenza, SARS, MERS-CoV, Legionella, Clostridium difficile NAP-1 strain, anthrax (bioterrorism), norovirus, iatrogenic fungal meningitis, cryptosporidiosis, and, more recently, Candida aris, Ebola, and Zika virus.
Each of these was unexpected and each presented a need for a response that usually included antimicrobial agents
and/or a vaccine. It would be fair to conclude that major pathogen surprises are predictable, but the when, where, and
what, is not.
Kucers’ THE USE OF ANTIBIOTICS A Clinical Review of Antibacterial, Antifungal, Antiparasitic, and Antiviral Drugs PDF –
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