Table 1. . Antimicrobial activities of nitric oxide-releasing platforms.
Platform | Advantages | Limitations | Active against |
---|---|---|---|
Acidified nitrite creams | Easily applied | Ingredients must be mixed immediately before application | Burkholderia cepacia |
Skin irritation | Mycobacterium ulcerans | ||
Propionibacterium acnes | |||
Pseudomonas aeruginosa | |||
Staphylococcus aureus (inc. MRSA) | |||
Tinea pedis | |||
|
|
|
Trichophyton spp. |
Diazeniumdiolates (NONOates) | Easily produced | Risk of methemoglobin formation and release of toxic and carcinogenic byproducts | Candida albicans (DETA-NO) |
Stable under ambient conditions | Escherichia coli (β-Gal-NONOate) | ||
|
Spontaneous release of NO in predictable and dependable fashion |
|
|
gNO | Little in vitro toxicity to human skin cells | Expensive | E. coli |
Difficult to handle | C. albicans | ||
Requires gas cylinders for delivery | P. aeruginosa | ||
Extended duration of treatment requiring nonambulation | S. aureus (inc. MRSA) | ||
Cannot be exposed to oxygen | Group B Streptococcus | ||
|
|
Potential host toxicity via NO2 production and methemoglobinemia development |
|
NO-releasing nanoparticles (NO-np) | Ease of synthesis, storage, and administration | Acinetobacter baumannii | |
Sustained NO retention and release | C. albicans | ||
Modifiable total NO quantity and rate of release | Enterococcus faecalis | ||
Minimal cutaneous and systemic toxicity | E. coli | ||
Klebsiella pneumoniae | |||
P. aeruginosa | |||
S. aureus (inc. MRSA) | |||
Staphylococcus epidermidis | |||
|
|
|
Trichophyton mentagrophytes |
NO probiotic patch | Inexpensive | Patch-to-patch variability of gNO production depending on activity of Lactobacillus fermentum in each patch | A. baumannii |
E. coli | |||
P. aeruginosa | |||
S. aureus (inc. MRSA) | |||
T. mentagrophytes | |||
|
|
|
Trichophyton rubrum |
Organic nitrates and nitrites (nitroglycerin, isosorbide mononitrate, sodium nitroprusside) | Long history of use | Limited knowledge of antimicrobial capabilities | Limited antibacterial properties |
Side effects well known | Tolerance development after prolonged use of nitrates | ||
|
|
Cyanide production by sodium nitroprusside |
|
S-nitrosothiols (RSNOs) | Tissue selective | Require refrigeration in powder form prior to use | Acanthamoeba castellanii |
Can be designed to release NO at specified rates | Lack stability required for localized/topical delivery | Enterobacter aerogenes | |
E. coli | |||
Leishmania spp. | |||
Plasmodium falciparum | |||
P. aeruginosa | |||
Coagulase-negative staphylococci | |||
Salmonella typhimurium | |||
Serratia marcescens | |||
S. aureus | |||
|
|
|
Trypanosoma cruzi |
Zeolites (NO-metal complexes) | Stable | Lack of investigation into potential use in SSTI | Bacillus subtilis |
Modifiable NO release rate | Clostridium difficile | ||
E. coli | |||
P. aeruginosa | |||
S. aureus (inc. MRSA) |
gNO: Gaseous nitric oxide; MRSA:Methicillin-resistant Staphylococcus aureus; NO: Nitric oxide; NONOate: Diazeniumdiolates; RSNO: Reactive nitrogen oxide species; SSTI: Skin and soft-tissue infection.