Abstract
The single antibiotic drug monotherapies have been used by clinicians in medical treatments of various infectious diseases including TB; however, World Health Organization accredited the rise of antimicrobial resistance bacterial pathogens, is a major global health crisis. As a result, a widely promising strategy known as antibiotic drug combination therapies have been designed to combat the evolution of drug-resistant pathogens, to enhance the current treatment efficacy by combining of more than two antibiotic drugs, and for the efficient treatment of numerous infectious diseases include Tuberculosis, HIV/AIDS, malaria. However, the disease-causing pathogens becoming resistant to multiple antibiotic drugs and can no longer be destroyed. One of the influencing factors of antibiotic drug combination treatment success failure is pathogen-host-antibiotic interaction which affect the combined drug outcomes and may influence evolution of multidrug-resistant strains. In such context, the main objective of this review paper was to assessed the impacts of pathogen-host-antibiotic interaction in the evolution and spread of multi-drug resistant pathogens against drug-combination therapy. Understanding the potential mechanisms of drug-drug, host-antibiotic and host-pathogen interactions help to inform decisions as to set-up in clinical settings in order to limit the evolution and spread of multi- drug resistant bacterial strains. Most significantly, in the near future sustainable bacterial infection therapies for potential adaptive pathogens include synergy-based drug combination and host-directed therapies in drug combination could be exercised to tackle the multi-drug resistance crisis by enhancing the combined drug treatment efficacy and prevent bacteria adapting to combination treatments.
Highlights
The single antibiotic drug monotherapies have been used by clinicians in medical treatments of various infectious diseases including tuberculosis (TB); World Health Organization accredited the rise of antimicrobial resistant bacterial pathogens, is a major global health crisis
The evolutionary adaptation and spread of multi-drug resistant (MDR) strains increase in drug combination therapy by impacting on the host-pathogen interactions in terms of protein and/or gene, for instance, the pathogen/ pattern recognition receptors (PRR) gene mutation interaction leads to improved bacterial growth in the host cell by evading the host immune system, and forming biofilms that greatly influence the outcome of infections by increasing the antibiotic treatment failure [33]
The two best strategies involved in drug combination therapy against drug-resistant strains have been explained, which are (i) synergy based drug-drug interactions in drug combination can slow down the evolution of resistance [15,17], studies on the selection of antibiotic pairs with different drug-drug epistatic interactions in drug combination for proper treatment strategies is too much limited
Summary
1- Department of Medical Biotechnology, Institute of Biotechnology, University of Gondar, Ethiopia. 2- Department of Veterinary Bacteriology, National Veterinary Institute (NVI), Bishoftu, Ethiopia. 3- Department of Biology, Faculty of Natural and Computational Science, University of Gondar, Ethiopia
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
