Antibiotic resistance and tolerance: What can drug delivery do against this global threat?
Juan Aparicio-Blanco, Nikhar Vishwakarma, Claus-Michael Lehr, Clive A Prestidge, Nicky Thomas, Richard J Roberts, Chelsea R Thorn, Ana Melero
Author Information
Juan Aparicio-Blanco: Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, 28040, Madrid, Spain.
Nikhar Vishwakarma: Department of Pharmacy, Gyan Ganga Institute of Technology and Sciences, Jabalpur, 482003, Madhya Pradesh, India.
Claus-Michael Lehr: Department Drug Delivery across Biological Barriers (DDEL), Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Saarbrücken, Germany.
Clive A Prestidge: Centre for Pharmaceutical Innovation, Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia.
Nicky Thomas: Centre for Pharmaceutical Innovation, Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia.
Richard J Roberts: New England Biolab, 240 County Road, Ipswich, MA, 01938-2723, USA.
Chelsea R Thorn: Biotherapeutics Pharmaceutical Research and Development, Pfizer, Inc., 1 Burtt Road, Andover, MA, 01810, USA. chelsea.thorn@pfizer.com.
Ana Melero: Department of Pharmacy and Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, 46100, Burjassot, Spain. ana.melero@uv.es. ORCID
Antimicrobial resistance and tolerance (AMR&T) are urgent global health concerns, with alarmingly increasing numbers of antimicrobial drugs failing and a corresponding rise in related deaths. Several reasons for this situation can be cited, such as the misuse of traditional antibiotics, the massive use of sanitizing measures, and the overuse of antibiotics in agriculture, fisheries, and cattle. AMR&T management requires a multifaceted approach involving various strategies at different levels, such as increasing the patient's awareness of the situation and measures to reduce new resistances, reduction of current misuse or abuse, and improvement of selectivity of treatments. Also, the identification of new antibiotics, including small molecules and more complex approaches, is a key factor. Among these, novel DNA- or RNA-based approaches, the use of phages, or CRISPR technologies are some potent strategies under development. In this perspective article, emerging and experienced leaders in drug delivery discuss the most important biological barriers for drugs to reach infectious bacteria (bacterial bioavailability). They explore how overcoming these barriers is crucial for producing the desired effects and discuss the ways in which drug delivery systems can facilitate this process.
