Table 2.
Antimicrobial therapies available and under investigation. 1 = therapies are commercially available; 2 = therapies are in clinical trial phase; 3 = therapies are in pre-clinical phase; 4 = commercially available in Europe. MRSA = Methicillin resistant Staphylcoccus aureus; MAC = Mycobacterium avium complex. Refs. [37,39,46,50,58,65,67,70,80,87,88,90,92,93].
| Antimicrobial Therapies | Mechanism of Action | Targeted Pathogen |
|---|---|---|
| Inhalation Antibiotics | ||
| Tobramycin 1 | Aminoglycoside; inhibits protein synthesis of Gram-negative bacteria |
Pseudomonas aeruginosa |
| Tobramycin dry powder 1 | ||
| Aztreonam 1 | Monobactam; inhibits cell wall synthesis against aerobic Gram-negative bacteria | |
| Levofloxacin 1 | Flouroquinolone; directly inhibits bacterial DNA synthesis | |
| Vancomycin 1 | Glycopeptide; inhibits Gram-positive bacterial cell wall synthesis | MRSA |
| Colistimethate 4 | Polymyxin derivative; disrupts the integrity of the bacterial cell membrane of most Gram-negative bacteria | Gram negative |
| Murepavadin 3 | Antimicrobial peptidomimetic; binds to the lipopolysaccharide transport protein in Gram-negative bacteria and causes cell death | Pseudomonas aeruginosa |
| Phage Therapy Studied Targets | ||
| Pseudomonas aeruginosa 2 | Viruses that infect specific bacteria and replicate the viral genome, ultimately lysing the host bacteria and killing it | As noted |
| Mycobacterium abscessus 3 | ||
| Staphylococcal aureus 3 | ||
| Achromobacter xylosoxidans 3 | ||
| Methicillin resistant Staphylcoccus aureus 3 | ||
| Other | ||
| Galium 2 | Disrupts iron-dependent processes necessary for bacterial survival and reproduction |
Pseudomonas aeruginosa MAC Mycobacterium abscessus |
| Nitric oxide 2 | Gas compound that breaks down biofilms and kills bacteria | MAC Mycobacterium abscessus |
| Sodium fusidate 2 | Protein synthesis inhibitor that prevents bacterial replication | MRSA Pseudomonas aeruginosa Staphylococcal aureus |
| Lefamulin 2 | A pleuromutilin antibacterial compound that binds to bacterial ribosome, preventing the binding of transfer RNA and inhibiting the production of protein | MRSA Staphylococcal aureus |
| Glycopolymer SNSP113 2 | Disrupts bacterial biofilms; has anti-inflammatory properties |
Staphylococcal aureus, MAC Mycobacterium abscessus |
| Opelconazole 2 | Synthetic triazole; prevents the formation of the fungi cell membrane, resulting in lysis | Aspergillus fumigatus |