Combination antibiotic
A combination antibiotic is one in which two ingredients are added together for additional therapeutic effect.[1] One or both ingredients may be antibiotics.[1]
Antibiotic combinations are increasingly important because of antimicrobial resistance.[2] This means that individual antibiotics that used to be effective are no longer effective,[1] and because of the absence of new classes of antibiotic, they allow old antibiotics to be continue to be used.[2] In particular, they may be required to treat multiresistant organisms,[1][2] such as carbapenem-resistant Enterobacteriaceae.[3] Some combinations are more likely to result in successful treatment of an infection.[1]
Uses
Antibiotics are used in combination for a number of reasons:
- to treat multiresistant organisms,[1][2] such as carbapenem-resistant Enterobacteriaceae.[3]
- Amoxicillin/clavulanic acid, which includes the beta lactam amoxicillin with the suicide inhibitor clauvanic acid, which helps the amoxicillin overcome the action of beta lactamase
- because a person may be infected with more than one microbe simultaneously,[3] for example infections of the abdominal cavity after bowel perforation.
- because antibiotics used together may act synergisticly to increase the efficacy of both,[3]
- because antibiotics used together may have a broader spectrum than each antibiotic used individually.[3]
Examples
Examples of combinations include:[citation needed]
- Amoxicillin/clavulanic acid, which includes the beta lactam amoxicillin with the suicide inhibitor clauvanic acid, which helps the amoxicillin overcome the action of beta lactamase
- Trimethoprim/sulfamethoxazole
Research
Research into combination antibiotics is ongoing.[1]
References
- ^ a b c d e f g Bassetti, Matteo; Righi, Elda (October 2015). "New antibiotics and antimicrobial combination therapy for the treatment of gram-negative bacterial infections". Current Opinion in Critical Care. 21 (5): 402–411. doi:10.1097/MCC.0000000000000235. PMID 26263298. S2CID 45984482.
- ^ a b c d Tyers, Mike; Wright, Gerard D. (25 January 2019). "Drug combinations: a strategy to extend the life of antibiotics in the 21st century". Nature Reviews Microbiology. 17 (3): 141–155. doi:10.1038/s41579-018-0141-x. PMID 30683887. S2CID 59259623.
- ^ a b c d e Ahmed, A; Azim, A; Gurjar, M; Baronia, AK (May 2014). "Current concepts in combination antibiotic therapy for critically ill patients". Indian Journal of Critical Care Medicine. 18 (5): 310–4. doi:10.4103/0972-5229.132495. PMC 4047693. PMID 24914260.