Tuberculosis still stands as the world’s leading infectious disease as 1/4th of the world’s population harbors Latent TB infection (LTBI) > 10 million develops active TB and ~ 1.5 million people die per year. Approximately 4,65,000 people fell ill with multidrug or rifampicin-resistant tuberculosis (MDR/RR-TB)/year. This deadly TB scenario demands new TB drug regimens to tackle global infection reservoir, and worldwide spread of drug resistance and DS TB. Successful entry of single new drug into market is much complicated mission owing to time, cost, efficacy, and safety issues. Therefore, drug repurposing seems one reliable hope to meet the challenges of modern TB drug discovery timely, as it starts with examining market acclaimed drugs against other diseases for their efficacies against tuberculosis avoiding several lengthy and costly steps required for new molecules. Several drugs have been identified, which show potential for TB treatment. There is need for careful consideration of various trial designs to ensure that TB phase III trials are initiated for fruitful development of new TB treatment regimens. TB drug repurposing will not only give fast track novel drugs but will also serve to identify new targets for future development in cost-effective manner.
Part of the book: Drug Repurposing
ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) are the prominent reasons of Healthcare-Acquired Infections (HAIs) with multidrug resistance against vancomycin, carbapenem, methicillin, and extended spectrum β-lactamases (ESBL). Multidrug resistance develops owing to inappropriate prescription, poor quality pharmaceuticals, patient non-compliance, and use of antimicrobials as growth promoters. The worst is the fact that resistance development and spread are continuous processes to the extent that present times are times of extensively drug resistant and totally drug resistant pathogens (confirmed worldwide). These dangerous pathogens pose global threat of the magnitude to the extent of reversing the situation to pre-antibiotic era as they have left majority of efficient antibiotics futile and estimates show expected death rates are 10 million/year by 2050. Considering this global havoc due to ESKAPEs intensive research from academia and industry is going on with significant success about the causes, mechanisms, spreading ways, and most importantly the novel/alternative strategies to combat them all. Substitute therapies such as combination use of antibiotics or immunomodulators/adjuvants with antibiotics, nanoparticles, antimicrobial peptides (AMPs), AMPs with antibodies, star polymers, and structurally nano-engineered antimicrobial peptide polymers (SNAPPs) all these aspects are well discussed and reviewed here.
Part of the book: Bacterial Infectious Diseases Annual Volume 2023