Journal of Literature Pharmacy Sciences

Antibiyotik Direncinin Aşılması İçin Yeni Stratejiler ve İlaç Geliştirme Çalışmaları: Geleneksel Derleme
New Strategies and Drug Development Studies for Overcoming Antibiotic Resistance: A Traditional Review
Algül Dilara DOKUMACIa
aKahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi, Tıbbi Farmakoloji ABD, Kahramanmaraş, Türkiye
J Lit Pharm Sci. 2024;13(1):57-68
doi: 10.5336/pharmsci.2023-99880
Article Language: TR
Full Text
ÖZET
 Antibiyotik direnci, en önemli antimikrobiyal ajanlarımızın işlevselliğini tehlikeye atan dünya çapında ciddi bir halk sağlığı sorunudur. Bu derlemenin amacı, antibiyotik direncine karşı mücadele etmek amacıyla ilaç geliştirmeye yönelik mevcut teknik ve çabaların kapsamlı bir incelemesini sunmaktır. İlk bölümde antibiyotik direncinden sorumlu mekanizmalar ele alınmakta, genetik mutasyonların, yatay gen aktarımının ve antibiyotiklerin gereksiz ve aşırı kullanımının dirence yol açmadaki önemi vurgulanmaktadır. Bu mekanizmaların kapsamlı bir şekilde kavranması, etkili önlemler geliştirmek için esastır. Sonraki bölümde, dirençle mücadele için öncü metodolojiler ele alınmıştır. Bunlar, direnç gelişimini azaltmak için birden fazla antibiyotiğin eş zamanlı olarak uygulanmasını gerektiren kombine tedavileri içermektedir. Ek olarak, belirli bakteri türlerini hedef alan dar spektrumlu antibiyotiklerin kullanıma sunulması, yararlı mikrobiyota üzerindeki zararlı etkileri azaltma potansiyeli taşımaktadır. Ayrıca faj terapisi ve antimikrobiyal peptidlerden oluşan alternatif tedaviler de incelenmiştir. Faj terapisi bakteriyofajlar kullanarak belirli bakteri türlerini hedeflerken, antimikrobiyal peptidler yenilikçi ilaç geliştirme potansiyeline sahiptir. Bununla birlikte, antibiyotik yönetim programlarının geliştirilmesi ve antibiyotik direnci modellerinin izlenmesi, mevcut antibiyotiklerin etkinliğini sürdürmek için çok önemlidir. Son bölümde, yenilikçi antibiyotik kategorilerinin analizi, önceden var olan ilaçların yeniden kullanımını ve ilaç keşfinde yapay zekânın kullanımı incelenmiştir. Yeni etki mekanizmalarına ve gelişmiş farmakokinetiğe sahip antibiyotiklerin geliştirilmesi, direncin önlenebilmesi için büyük önem taşımaktadır. Antibiyotik direnci, küresel sağlık için önemli bir tehlike oluşturmaktadır ve bu krizin ele alınması çok yönlü bir strateji gerektirmektedir. Antibiyotik direncine karşı mücadele, yeni taktiklerin yanı sıra sürekli araştırma ve ilaç geliştirme çabalarını da gerektirmektedir. Burada sunulan kapsamlı derleme, mevcut araştırmaların kapsamlı bir incelemesini sunmakta ve bu kritik alanda gelecekteki çabalar için teşvik edici yolları tanımlamaktadır.

Anahtar Kelimeler: Antibiyotik direnci; direnç mekanizmaları; dar spektrumlu antibiyotikler; ilaç geliştirme; kombinasyon tedavisi
ABSTRACT
 Antibiotic resistance is a serious worldwide public health problem that compromises the functionality of our most important antimicrobial agents. The purpose of this review is to provide a comprehensive review of current techniques and efforts to develop drugs to combat antibiotic resistance. In the first part, the mechanisms responsible for antibiotic resistance are discussed, and the importance of genetic mutations, horizontal gene transfer, and unnecessary and excessive use of antibiotics in leading to resistance is emphasized. A thorough understanding of these mechanisms is essential for developing effective measures. In the next section, pioneering methodologies for combating resistance are discussed. These include combined therapies that require simultaneous administration of multiple antibiotics to reduce the development of resistance. In addition, the introduction of narrow-spectrum antibiotics that target specific types of bacteria has the potential to reduce the harmful effects on the beneficial microbiota. In addition, alternative therapies consisting of phage therapy and antimicrobial peptides were also examined. While phage therapy targets specific types of bacteria using bacteriophages, antimicrobial peptides have the potential to develop innovative drugs. Also, the development of antibiotic management programs and monitoring of antibiotic resistance patterns are crucial to maintaining the effectiveness of current antibiotics. In the final section, the analysis of innovative categories of antibiotics, the reuse of pre-existing drugs, and the use of artificial intelligence in drug discovery are examined. The development of antibiotics with novel mechanisms of action and improved pharmacokinetics is of great importance for the prevention of resistance. The fight against antibiotic resistance requires not only new tactics but also continuous research and drug development efforts. The comprehensive review presented here provides an in-depth examination of current research and identifies encouraging pathways for future endeavors in this critical field.

Keywords: Antibiotic resistance; resistance mechanisms; narrow-spectrum antibiotics; drug development; combination therapy
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