Abstract
The present review covers combination approaches of antimicrobial photodynamic therapy (aPDT) plus antibiotics or antifungals to attack bacteria and fungi in vitro (both planktonic and biofilm forms) focused on those microorganisms that cause infections in skin and soft tissues. The combination can prevent failure in the fight against these microorganisms: antimicrobial drugs can increase the susceptibility of microorganisms to aPDT and prevent the possibility of regrowth of those that were not inactivated during the irradiation; meanwhile, aPDT is effective regardless of the resistance pattern of the strain and their use does not contribute to the selection of antimicrobial resistance. Additive or synergistic antimicrobial effects in vitro are evaluated and the best combinations are presented. The use of combined treatment of aPDT with antimicrobials could help overcome the difficulty of fighting high level of resistance microorganisms and, as it is a multi-target approach, it could make the selection of resistant microorganisms more difficult.
Highlights
The most limitation is the possibility microbial regrowth by those who have not been inactivated during irradiation independently of their pattern of Antimicrobial resistance (AMR), without its use contributing to theThe selection combination of antimicrobial photodynamic therapy (aPDT) with antibiotic or antifungal treatment is a promising approach to drug‐resistant strains, and its broad spectrum of activity; it does not require the fight against infectious diseases due to aPDT’s ability to increase the susceptibility of precise microbial diagnosis and itdrugs is very forthe infections by several microorganisms to antimicrobial anduseful minimize possibilitycaused of the regrowth after microo ganisms
Results of Studies on In Vitro aPDT Combined with Antimicrobial Agents against
S. aureus, frequently involved in the problem of AMR, is the main causative agent of soft tissue infections (SSTIs) and represents one of the most important pathogens involved in Complicated forms of SSTI (cSSTI) [2,25,26]
Summary
Skin and soft tissue infections (SSTIs) are defined as clinical entities of variable presentation, etiology, and severity that involve microbial invasion of the layers of the skin and underlying soft tissues. Complicated forms of SSTI (cSSTI) may need, apart from antibiotic or antifungal treatment, surgical procedures, or have significant underlying co-morbidities such as diabetes, systemic immunosuppression, or neurological diseases [4,5,6]. Their treatment has become more challenging because of the increase in the frequency and severity of infections mainly due to the ageing of the general population, the increased number of critical and immunocompromised patients, and because of the emergence. Pharmaceuticals 2021, 14, 603 of resistance to many of the antimicrobial agents commonly used to treat SSTIs in the past [7,8,9]
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