RESUSCITATING AND REPURPOSING OLDER ANTIBIOTICS FOR COMBATING INFECTIONS OF MDR BACTERIA

The increased occurrence of community and nosocomial infections caused by multiple drug-resistant bacteria has become a serious challenge for effective chemotherapy. Moreover, this alarming state of drug resistance evolution has not been compensated by the development of novel antibacterial agents. The emergence of resistance in newer antibiotics is an issue of grave concern. In this context, old antibiotics are being revisited or revived and their rational usage can make them an alternative remedy in combating the infections of MDR bacteria. The therapeutic armamentarium of antibiotics would also be optimized by preserving novel antibacterial drugs for future application. Furthermore, at the time of these drug approval pharmacokinetic and pharmacodynamic data were unknown and there was difficulty in dosing recommendations and dose-finding for their optimal usage in health care settings. In this chapter, an attempt has been made to provide a brief overview of the methodology of resistance prediction as well as the challenges associated with rejuvenating the older antibiotics, the need for resuscitating older antibiotics for hospital and community-acquired infections, and the strategies to redevelop these drugs including the involvement of standard methods, incorporating knowledge into regulatory frameworks, dose justification and optimization and filling the knowledge gaps from the research bench to bedside