Synergistic Approaches to Combatting Polymyxin-Resistant Microbial Strains in Hospital Settings: Diagnostics, Clinical Outcomes, Policy Implications and Current Challenges in Treating
Abstract
Polymyxins include polymyxin B and colistin, antibiotics which have played a crucial role as last resorts in the treatment of drug-resistant Gram-negative bacterial infections. Nevertheless, the increasing emergence of strains resistant to polymyxins has posed considerable clinical treatment challenges that risk the world's public health. Such resistance mechanisms include lipid A modification, efflux pumps, and plasmid-mediated mcr genes. These mechanisms render the polymyxins less potent, thus complicating infection control in clinical settings, especially hospitals. The present strategies against resistance are combination therapies: polymyxin with β-lactams, EDTA adjuvants, non-antibiotic approaches-nanoparticles, and phage therapy. Better diagnostics together with antimicrobial stewardship programs will control the spreading of resistance. MALDI-TOF and Rapid Polymyxin NP test can rapidly diagnose the diseases that can treat quickly. The development of solutions like host-based therapies, immunotherapy, and safer polymyxin analogues will be useful to cope with this crucial challenge. It pays more attention toward research and development of the novel therapy for polymyxin-resistant infections by providing much emphasis on global cooperation as well as government policies on combating the problem of antimicrobial resistance.