Dataset Information

Shifting Gears: The Future of Polymyxin Antibiotics.

ABSTRACT: The manuscripts contained in this special edition of Antibiotics represent a current review of the polymyxins as well as highlights from the 3rd International Polymyxin Conference, which was held in Madrid, Spain, April 25 to 26, 2018. The role of the polymyxin antibiotics has evolved over time based on the availability of alternative agents. After high rates of nephrotoxicity caused the drug class to fall out of favor, polymyxins were once against utilized in the 21st century to combat drug-resistant pathogens. However, the introduction of safer agents with activity against drug-resistant organisms has brought the future utility of polymyxins into question. The present review investigates the future niche of polymyxins by evaluating currently available and future treatment options for difficult-to-treat pathogens. The introduction of ceftazidime-avibactam, meropenem-vaborbactam and plazomicin are likely to decrease polymyxin utilization for infections caused by Enterobacteriaceae. Similarly, the availability of ceftolozane-tazobactam will reduce the use of polymyxins to counter multidrug-resistant Pseudomonas aeruginosa. In contrast, polymyxins will likely continue be an important option for combatting carbapenem-resistant Acinetobacter baumannii until better options become commercially available. Measuring polymyxin concentrations in patients and individualizing therapy may be a future strategy to optimize clinical outcomes while minimizing nephrotoxicity. Inhaled polymyxins will continue to be an adjunctive option for pulmonary infections but further clinical trials are needed to clarify the efficacy of inhaled polymyxins. Lastly, safer polymyxin analogs will potentially be an important addition to the antimicrobial armamentarium.

SUBMITTER: Lenhard JR

PROVIDER: S-EPMC6628003 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Shifting Gears: The Future of Polymyxin Antibiotics.

Lenhard Justin R JR Bulman Zackery P ZP Tsuji Brian T BT Kaye Keith S KS

Antibiotics (Basel, Switzerland) 20190412 2

The manuscripts contained in this special edition of Antibiotics represent a current review of the polymyxins as well as highlights from the 3rd International Polymyxin Conference, which was held in Madrid, Spain, April 25 to 26, 2018. The role of the polymyxin antibiotics has evolved over time based on the availability of alternative agents. After high rates of nephrotoxicity caused the drug class to fall out of favor, polymyxins were once against utilized in the 21st century to combat drug-res ...[more]

PMID: 31013818

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Project description:Mosaic landscapes under shifting cultivation, with their dynamic mix of managed and natural land covers, often fall through the cracks in remote sensing-based land cover and land use classifications, as these are unable to adequately capture such landscapes' dynamic nature and complex spectral and spatial signatures. But information about such landscapes is urgently needed to improve the outcomes of global earth system modelling and large-scale carbon and greenhouse gas accounting. This study combines existing global Landsat-based deforestation data covering the years 2000 to 2014 with very high-resolution satellite imagery to visually detect the specific spatio-temporal pattern of shifting cultivation at a one-degree cell resolution worldwide. The accuracy levels of our classification were high with an overall accuracy above 87%. We estimate the current global extent of shifting cultivation and compare it to other current global mapping endeavors as well as results of literature searches. Based on an expert survey, we make a first attempt at estimating past trends as well as possible future trends in the global distribution of shifting cultivation until the end of the 21st century. With 62% of the investigated one-degree cells in the humid and sub-humid tropics currently showing signs of shifting cultivation-the majority in the Americas (41%) and Africa (37%)-this form of cultivation remains widespread, and it would be wrong to speak of its general global demise in the last decades. We estimate that shifting cultivation landscapes currently cover roughly 280 million hectares worldwide, including both cultivated fields and fallows. While only an approximation, this estimate is clearly smaller than the areas mentioned in the literature which range up to 1,000 million hectares. Based on our expert survey and historical trends we estimate a possible strong decrease in shifting cultivation over the next decades, raising issues of livelihood security and resilience among people currently depending on shifting cultivation.

Dataset Information

Shifting Gears: The Future of Polymyxin Antibiotics.

Publications

Shifting Gears: The Future of Polymyxin Antibiotics.

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