Although all existing antimicrobials were selected for their efficacy against planktonic cultures and this efficacy has not always translated to activity against biofilms, it may still be possible to make better use of existing antimicrobials to treat biofilm disease.
BETTER USE OF EXISTING ANTIMICROBIALS
Although all existing
antimicrobials were selected for their efficacy against planktonic cultures and
this efficacy has not always translated to activity against biofilms, it may
still be possible to make better use of existing anti-microbials to treat
biofilm disease. A marked trend in treating chronic infections of many kinds is
the use of antibiotic combinations. The possible existence of synergies between
existing anti-microbials represents one area of progress in treating biofilm
infections. Rational approaches to the application of combinations of anti-microbials,
based on the differences of their targets, have not provided clear use predictions.
Most combinations are still empirically derived from past experience. The
bioFILM PA assay used to select combinations of antibiotics for the treatment
of Ps. aeruginosa lung infections in
cystic fibrosis patients is one of the first diagnostics to receive regulatory
approval (in Canada) and has had a measure of success in the treatment of
seriously ill patients. This test is now in clinical trials as a standard
diagnostic in cystic fibrosis. Based on the Calgary Biofilm Device, which is
the only high through put device for selecting anti-microbials with efficacy
against biofilms, this represents one of the first attempts to address the
differences in susceptibility of organisms in the biofilm growth mode.
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