The future of antibiotics begins with discovering new combinations,Annals of the New York Academy of Sciences

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The future of antibiotics begins with discovering new combinations
Annals of the New York Academy of Sciences ( IF 4.1 ) Pub Date : 2021-07-02 , DOI: 10.1111/nyas.14649
Meilin Zhu _{1,

2} , Megan W Tse _{1,

2} , Juliane Weller ₂ , Julie Chen _{1,

2,

3} , Paul C Blainey _{1,

2,

4}

Affiliation

Antibiotic resistance is a worldwide and growing clinical problem. With limited drug development in the antibacterial space, combination therapy has emerged as a promising strategy to combat multidrug-resistant bacteria. Antibacterial combinations can improve antibiotic efficacy and suppress antibacterial resistance through independent, synergistic, or even antagonistic activities. Combination therapies are famously used to treat viral and mycobacterial infections and cancer. However, antibacterial combinations are only now emerging as a common treatment strategy for other bacterial infections owing to challenges in their discovery, development, regulatory approval, and commercial/clinical deployment. Here, we focus on discovery—where the sheer scale of combinatorial chemical spaces represents a significant challenge—and discuss how combination therapy can impact the treatment of bacterial infections. Despite these challenges, recent advancements, including new in silico methods, theoretical frameworks, and microfluidic platforms, are poised to identify the new and efficacious antibacterial combinations needed to revitalize the antibacterial drug pipeline.

中文翻译：

抗生素的未来始于发现新的组合

抗生素耐药性是一个世界范围内日益严重的临床问题。由于抗菌领域的药物开发有限，联合治疗已成为对抗多重耐药细菌的一种有前途的策略。抗菌组合可以通过独立、协同甚至拮抗活性提高抗生素功效并抑制抗菌耐药性。联合疗法广泛用于治疗病毒和分枝杆菌感染以及癌症。然而，由于其发现、开发、监管批准和商业/临床部署方面的挑战，抗菌组合现在才成为其他细菌感染的常见治疗策略。在这里，我们重点关注发现——组合化学空间的巨大规模代表着重大挑战——并讨论联合疗法如何影响细菌感染的治疗。尽管存在这些挑战，但最近的进展，包括新的计算机方法、理论框架和微流体平台，有望确定振兴抗菌药物管道所需的新型有效抗菌组合。

更新日期：2021-07-18

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