Bacteria in the respiratory tract—how to treat? Or do not treat?
Background: Acute and chronic respiratory tract infections are a common cause of inappropriate antimicrobial prescription. Antimicrobial therapy leads to the development of resistance and the emergence of opportunistic pathogens that substitute the indigenous microbiota. Methods: This review explore...
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doaj-8fcecb9c5ecc4f8da82c75dd646224e72020-11-24T22:17:05ZengElsevierInternational Journal of Infectious Diseases1201-97121878-35112016-10-0151C11312210.1016/j.ijid.2016.09.005Bacteria in the respiratory tract—how to treat? Or do not treat?Cristina Prat0Alicia Lacoma1Microbiology Department, Hospital Universitari Germans Trias i Pujol, Institut d’Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Ctra del Canyet s/n, 08916 Badalona, Barcelona, SpainMicrobiology Department, Hospital Universitari Germans Trias i Pujol, Institut d’Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Ctra del Canyet s/n, 08916 Badalona, Barcelona, SpainBackground: Acute and chronic respiratory tract infections are a common cause of inappropriate antimicrobial prescription. Antimicrobial therapy leads to the development of resistance and the emergence of opportunistic pathogens that substitute the indigenous microbiota. Methods: This review explores the major challenges and lines of research to adequately establish the clinical role of bacteria and the indications for antimicrobial treatment, and reviews novel therapeutic approaches. Results: In patients with chronic pulmonary diseases and structural disturbances of the bronchial tree or the lung parenchyma, clinical and radiographic signs and symptoms are almost constantly present, including a basal inflammatory response. Bacterial adaptative changes and differential phenotypes are described, depending on the clinical role and niche occupied. The respiratory tract has areas that are potentially inaccessible to antimicrobials. Novel therapeutic approaches include new ways of administering antimicrobials that may allow intracellular delivery or delivery across biofilms, targeting the functions essential for infection, such as regulatory systems, or the virulence factors required to cause host damage and disease. Alternatives to antibiotics and antimicrobial adjuvants are under development. Conclusions: Prudent treatment, novel targets, and improved drug delivery systems will contribute to reduce the emergence of antimicrobial resistance in lower respiratory tract infections.http://www.sciencedirect.com/science/article/pii/S1201971216311626Lower respiratory tract infectionBacterial colonizationNovel therapeutic approachesAlternatives to antibioticsPrudent use of antibiotics |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Cristina Prat Alicia Lacoma |
spellingShingle |
Cristina Prat Alicia Lacoma Bacteria in the respiratory tract—how to treat? Or do not treat? International Journal of Infectious Diseases Lower respiratory tract infection Bacterial colonization Novel therapeutic approaches Alternatives to antibiotics Prudent use of antibiotics |
author_facet |
Cristina Prat Alicia Lacoma |
author_sort |
Cristina Prat |
title |
Bacteria in the respiratory tract—how to treat? Or do not treat? |
title_short |
Bacteria in the respiratory tract—how to treat? Or do not treat? |
title_full |
Bacteria in the respiratory tract—how to treat? Or do not treat? |
title_fullStr |
Bacteria in the respiratory tract—how to treat? Or do not treat? |
title_full_unstemmed |
Bacteria in the respiratory tract—how to treat? Or do not treat? |
title_sort |
bacteria in the respiratory tract—how to treat? or do not treat? |
publisher |
Elsevier |
series |
International Journal of Infectious Diseases |
issn |
1201-9712 1878-3511 |
publishDate |
2016-10-01 |
description |
Background: Acute and chronic respiratory tract infections are a common cause of inappropriate antimicrobial prescription. Antimicrobial therapy leads to the development of resistance and the emergence of opportunistic pathogens that substitute the indigenous microbiota.
Methods: This review explores the major challenges and lines of research to adequately establish the clinical role of bacteria and the indications for antimicrobial treatment, and reviews novel therapeutic approaches.
Results: In patients with chronic pulmonary diseases and structural disturbances of the bronchial tree or the lung parenchyma, clinical and radiographic signs and symptoms are almost constantly present, including a basal inflammatory response. Bacterial adaptative changes and differential phenotypes are described, depending on the clinical role and niche occupied. The respiratory tract has areas that are potentially inaccessible to antimicrobials. Novel therapeutic approaches include new ways of administering antimicrobials that may allow intracellular delivery or delivery across biofilms, targeting the functions essential for infection, such as regulatory systems, or the virulence factors required to cause host damage and disease. Alternatives to antibiotics and antimicrobial adjuvants are under development.
Conclusions: Prudent treatment, novel targets, and improved drug delivery systems will contribute to reduce the emergence of antimicrobial resistance in lower respiratory tract infections. |
topic |
Lower respiratory tract infection Bacterial colonization Novel therapeutic approaches Alternatives to antibiotics Prudent use of antibiotics |
url |
http://www.sciencedirect.com/science/article/pii/S1201971216311626 |
work_keys_str_mv |
AT cristinaprat bacteriaintherespiratorytracthowtotreatordonottreat AT alicialacoma bacteriaintherespiratorytracthowtotreatordonottreat |
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