Expert Review of Anti-infective Therapy最新文献

Metabolic outcomes of bictegravir/emtricitabine/tenofovir alafenamide versus dolutegravir/lamivudine in treatment-naïve people living with HIV: a 48-week retrospective study. 比替格拉韦/恩曲他滨/替诺福韦阿拉胺与多替格拉韦/拉米夫定在treatment-naïve HIV感染者中的代谢结局：一项为期48周的回顾性研究

IF 3.8 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-05-07 DOI: 10.1080/14787210.2026.2669583

Yifan Guo, Jiantao Fu, Jingxia Wang, Lulu Xing, Jialu Li, Chengyu Gao, Yining Zhao, Qinlan Li, Yi Ding, Jiang Xiao, Hongxin Zhao

{"title":"Metabolic outcomes of bictegravir/emtricitabine/tenofovir alafenamide versus dolutegravir/lamivudine in treatment-naïve people living with HIV: a 48-week retrospective study.","authors":"Yifan Guo, Jiantao Fu, Jingxia Wang, Lulu Xing, Jialu Li, Chengyu Gao, Yining Zhao, Qinlan Li, Yi Ding, Jiang Xiao, Hongxin Zhao","doi":"10.1080/14787210.2026.2669583","DOIUrl":"10.1080/14787210.2026.2669583","url":null,"abstract":"Background: Although the high efficacy and safety of bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) and dolutegravir/lamivudine (DTG/3TC) in treatment-naïve people living with HIV (PLWH) have been well established, their metabolic effects remain a concern.Research design and methods: We retrospectively analyzed 499 treatment-naïve PLWH who initiated BIC/FTC/TAF or DTG/3TC at Beijing Ditan Hospital between January 2021 and December 2023 to compare metabolic outcomes over a 48-week follow-up period.Results: Compared to DTG/3TC, the BMI at week 48 was higher in participants receiving BIC/FTC/TAF (24.65 vs. 23.14 kg/m2, p = 0.023) after propensity score matching, with a greater increase from baseline (+1.10 vs. +0.71 kg/m2, p = 0.011). PLWH receiving BIC/FTC/TAF exhibited an increase in uric acid over 48 weeks (median change 5 μmol/L vs. -6 μmol/L, adjusted change p = 0.034). No significant between-group differences were observed in the changes of lipid, glucose and renal parameters over 48 weeks. Both regimens achieved similar virologic suppression (95.5% vs. 94.5%, p = 0.857) and comparable CD4 recovery (+188 vs. +173 cells/μL, p = 0.726).Conclusion: In this cohort of treatment-naïve PLWH, initiation of BIC/FTC/TAF or DTG/3TC achieved comparable metabolic outcomes, immunologic and virologic after 48 weeks, while BIC/FTC/TAF was associated with significantly increases in BMI.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-8"},"PeriodicalIF":3.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Overview of novel cefepime-based β-lactam/β-lactamase inhibitor combinations. 基于头孢吡肟的新型β-内酰胺/β-内酰胺酶抑制剂组合综述。

IF 3.8 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-05-06 DOI: 10.1080/14787210.2026.2669588

Luca Pipitò, Antonio Cascio

{"title":"Overview of novel cefepime-based β-lactam/β-lactamase inhibitor combinations.","authors":"Luca Pipitò, Antonio Cascio","doi":"10.1080/14787210.2026.2669588","DOIUrl":"https://doi.org/10.1080/14787210.2026.2669588","url":null,"abstract":"Introduction: The global rise of multidrug-resistant (MDR) Gram-negative pathogens challenges therapy, driving development of novel β-lactam/β-lactamase inhibitor (BL/BLI) combinations. Cefepime-based combinations offer mechanistically diverse options against a broad range of resistance phenotypes.Areas covered: This review summarizes approved and investigational cefepime-based BL/BLI combinations, including cefepime/enmetazobactam (FEP/EMT), cefepime/taniborbactam (FTB), cefepime/zidebactam (FPZ), and cefepime/nacubactam (FEP/NAC). We discuss microbiological activity, resistance mechanisms, pharmacokinetics/pharmacodynamics, and available clinical evidence. In vitro data show differential activity against ESBL-, AmpC-, and carbapenemase-producing Enterobacterales, as well as difficult-to-treat Pseudomonas aeruginosa, with emerging but limited clinical outcomes. Challenges include incomplete resistance coverage, geographic variability, and limited clinical trials.Expert opinion: Cefepime-based BL/BLI therapy should be pathogen- and mechanism-driven. FEP/EMT is suited for ESBL- and AmpC-producing Enterobacterales, potentially sparing carbapenems and covering OXA producers if susceptible. FTB may target severe carbapenem-resistant Enterobacterales infections resistant to existing BL/BLI agents, considering coverage for metallo-β-lactamases (MBL). FPZ combines β-lactamase inhibition and β-lactam-enhancer activity, retaining activity against XDR Enterobacterales and P. aeruginosa, including cefiderocol- or aztreonam/avibactam (ATM/AVI)-resistant strains. FEP/NAC shows promise against carbapenem- and MBL-producing strains, though clinical data remain limited. Optimal use relies on rapid molecular diagnostics, susceptibility testing, and antimicrobial stewardship to maximize efficacy and limit the emergence of resistance.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-16"},"PeriodicalIF":3.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tigecycline use in children with Multidrug-Resistant Infections: A single-center experience. 替加环素在耐多药感染儿童中的应用：单中心经验。

IF 3.8 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-05-05 DOI: 10.1080/14787210.2026.2670678

Mustafa Gençeli, Talha Üstüntaş, Özge Metin Akcan, Melda Özdemir, Hatice Kübra Körpe Boğaz, Betül Cığal, Kübranur Erdoğan, Abdullah Akkuş, Abdülkerim Çokbiçer

{"title":"Tigecycline use in children with Multidrug-Resistant Infections: A single-center experience.","authors":"Mustafa Gençeli, Talha Üstüntaş, Özge Metin Akcan, Melda Özdemir, Hatice Kübra Körpe Boğaz, Betül Cığal, Kübranur Erdoğan, Abdullah Akkuş, Abdülkerim Çokbiçer","doi":"10.1080/14787210.2026.2670678","DOIUrl":"https://doi.org/10.1080/14787210.2026.2670678","url":null,"abstract":"Background: Pediatric data on tigecycline for multidrug-resistant infections caused by gram-negative bacteria remain scarce. We described clinical outcomes and tolerability of tigecycline in critically ill children at a single tertiary center.Research design and methods: In this retrospective cohort study, 143 pediatric patients receiving tigecycline (1-1.2 mg/kg or 50 mg twice daily) between January 2018 and September 2023 were analyzed. Most patients (72.0%) required intensive care; 66.4% received combination therapy. Primary outcome was clinical success (infection resolution with marker normalization). Logistic regression and Cox modeling assessed success and mortality predictors; Kaplan-Meier curves compared survival. Paired laboratory data assessed tolerability.Results: Klebsiella pneumoniae (72.0%) and Acinetobacter baumannii (17.5%) predominated; 87% of isolates displayed carbapenem resistance. Clinical success reached 76.9%. Intensive care admission and combination therapy independently predicted failure. Overall infection-related mortality was 28.7%; intensive care admission was the sole independent mortality predictor. Paired laboratory values showed no significant hepatic, pancreatic, or hematological changes; one biliary sludge event was recorded.Conclusions: Tigecycline, a glycylcycline antimicrobial, was associated with favorable outcomes and acceptable tolerability in children with multidrug-resistant infections. The single-center retrospective design, absence of a control group, and frequent concomitant antibiotic use limit generalizability; prospective trials are needed.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Precision antibiotic treatment in intensive care unit-acquired lower respiratory tract infections (ICU-LRTIs): contemporary concepts and future directions. 重症监护病房获得性下呼吸道感染（ICU-LRTIs）的精确抗生素治疗：当代概念和未来方向。

IF 3.8 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-04-01 Epub Date: 2026-04-22 DOI: 10.1080/14787210.2026.2663102

Ignacio Martín-Loeches, Marc Leone, Luis Felipe Reyes, Andrew Conway-Morris, Lene Russell, Tee Keat Teoh, Alejandro Rodríguez

{"title":"Precision antibiotic treatment in intensive care unit-acquired lower respiratory tract infections (ICU-LRTIs): contemporary concepts and future directions.","authors":"Ignacio Martín-Loeches, Marc Leone, Luis Felipe Reyes, Andrew Conway-Morris, Lene Russell, Tee Keat Teoh, Alejandro Rodríguez","doi":"10.1080/14787210.2026.2663102","DOIUrl":"10.1080/14787210.2026.2663102","url":null,"abstract":"Introduction: Intensive care unit-acquired lower respiratory tract infections (ICU-LRTIs), including ventilator-associated pneumonia (VAP), ventilator-associated tracheobronchitis (VAT), and hospital-acquired pneumonia (vHAP) requiring invasive ventilation, remain among the most frequent and complex infections in critical care. Their management is challenged by diagnostic uncertainty, overlapping syndromes, and rising antimicrobial resistance. Despite advances in diagnostic and therapeutic tools, empirical broad-spectrum antibiotics remain the cornerstone of treatment, often started without microbiological confirmation.Areas covered: This narrative review examines current approaches to ICU-LRTIs, with a focus on the growing role of bronchoscopy, molecular diagnostics, host biomarkers, and therapeutic drug monitoring (TDM). The need for harmonized definitions, such as ventilator-associated lower respiratory tract infection (VA-LRTI), is discussed to address diagnostic variability. The review also considers combined therapies, including nebulized antibiotics, novel antimicrobials targeting multidrug-resistant pathogens, and real-time TDM to optimize treatment in complex ICU cases.Expert opinion: Management of VA-LRTIs is moving toward precision-guided care. Integrating bronchoscopy, molecular testing, and host-response profiling into routine practice can enable earlier, targeted therapy. Real-time TDM and local resistance surveillance should be standard to optimize antimicrobial use and prevent resistance. A shift from rigid syndromic classifications toward phenotype-driven management is needed to improve patient outcomes.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"381-392"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dengue in a warming world: changing epidemiology, vaccines, and therapeutic developments. 全球变暖中的登革热：流行病学变化、疫苗和治疗发展。

IF 3.8 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-04-01 Epub Date: 2026-04-23 DOI: 10.1080/14787210.2026.2662312

Francesca F Norman, Ralph Huits, Lin H Chen

{"title":"Dengue in a warming world: changing epidemiology, vaccines, and therapeutic developments.","authors":"Francesca F Norman, Ralph Huits, Lin H Chen","doi":"10.1080/14787210.2026.2662312","DOIUrl":"10.1080/14787210.2026.2662312","url":null,"abstract":"Introduction: Dengue has emerged as the most widespread and rapidly increasing vector-borne disease globally and is currently a global public health threat. Geographical, environmental, host and/or vector-specific factors can act as drivers of dengue epidemics globally.Areas covered: The current dengue virus distribution and the geographical expansion of competent Aedes spp. vectors are reviewed. Recent advances in vaccine development and novel treatment options under evaluation are highlighted, including novel antivirals and monoclonal antibodies.Expert opinion: Climate change and human-related factors are driving the global expansion of dengue risk, including in temperate regions. While licensed vaccines offer new prevention opportunities, limitations remain, especially for vulnerable populations. Continued research into effective antivirals and innovative vaccines is critical. A multidisciplinary approach integrating vector control, vaccination, and emerging therapies is essential to address the growing dengue burden in a warming world.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"363-380"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unmet targets: evaluating vancomycin use and predictive factors of target attainment in hemodialysis patients. 未达到目标：评估血液透析患者万古霉素的使用和目标达到的预测因素。

IF 3.8 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-04-01 Epub Date: 2026-04-28 DOI: 10.1080/14787210.2026.2665224

Van Dong Nguyen, Philip Ouimet, Alice Dion-Laplante, Stéphanie Crête, Sarah Dabouz, France Dion, Vlad Alexandru Rosu, Marie-Ève Legris, Amélie Marsot

{"title":"Unmet targets: evaluating vancomycin use and predictive factors of target attainment in hemodialysis patients.","authors":"Van Dong Nguyen, Philip Ouimet, Alice Dion-Laplante, Stéphanie Crête, Sarah Dabouz, France Dion, Vlad Alexandru Rosu, Marie-Ève Legris, Amélie Marsot","doi":"10.1080/14787210.2026.2665224","DOIUrl":"10.1080/14787210.2026.2665224","url":null,"abstract":"Background: Vancomycin is commonly prescribed in hemodialysis (HD) patients, who are highly susceptible to infections. Although HD-specific dosing targets have recently emerged, considerable practice variability persists, highlighting the need to standardize vancomycin therapeutic drug monitoring (TDM).Research design and methods: This multicenter retrospective study describes local practice of vancomycin dosing and monitoring, measures attainment of vancomycin target concentration range (trough: 15-20 mg/L), and identifies predictors of attainment of TDM target in HD patients. Data was collected from patients on chronic intermittent high-flux HD who received vancomycin in two Canadian health centers from 1 January 2019 to 31 December 2022.Results: 453 treatment courses, corresponding to 261 patients, were analyzed. Target attainment varied in both centers. The median (IQR) target attainment during a treatment course was 16.7% (0-50%) across all courses. Residual diuresis (OR = 0.48, 95% CI [0.28, 0.83]) and shorter treatment duration (OR = 0.91, 95% CI [0.87, 0.97]) were associated with worse target attainment.Conclusions: This study highlights the high rate of 0% target trough concentration attainment per treatment course in our centers and identifies patients with residual diuresis and/or early stages of treatment (less than 7 days) as populations that may benefit from closer vancomycin TDM.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"449-459"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy and safety of gepotidacin versus standard of-care antibiotics for the treatment of uncomplicated urogenital infections in adults and adolescents: a systematic review and meta-analysis. Gepotidacin与标准护理抗生素治疗成人和青少年无并发症泌尿生殖器感染的疗效和安全性：一项系统回顾和荟萃分析。

IF 3.8 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-04-01 Epub Date: 2026-05-06 DOI: 10.1080/14787210.2026.2667361

Mounika Reddy, Vishakha Jain, Madhavi Eerike, Manasa Reddy, Debasis Bisoi, Vahini Golla, Gerard Marshall Raj

{"title":"Efficacy and safety of gepotidacin versus standard of-care antibiotics for the treatment of uncomplicated urogenital infections in adults and adolescents: a systematic review and meta-analysis.","authors":"Mounika Reddy, Vishakha Jain, Madhavi Eerike, Manasa Reddy, Debasis Bisoi, Vahini Golla, Gerard Marshall Raj","doi":"10.1080/14787210.2026.2667361","DOIUrl":"10.1080/14787210.2026.2667361","url":null,"abstract":"Background: Gepotidacin, a novel oral antibacterial targeting bacterial DNA gyrase and topoisomerase IV, exhibits potent activity against Escherichia coli and Neisseria gonorrhoeae resistant strains. This systematic review and meta-analysis assessed the efficacy and safety of gepotidacin compared with standard-of-care antibiotics in adults and adolescents with uncomplicated urogenital infections.Methods: Randomized controlled trials comparing gepotidacin with standard antibiotic regimens for uncomplicated urinary tract infections or urogenital gonorrhea were included. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for microbiological success, clinical cure, and serious adverse events (SAEs). Risk of bias and certainty of evidence were assessed using the Cochrane RoB2 tool and GRADE approach, respectively.Results: Three phase 3 trials (EAGLE-1, EAGLE-2, EAGLE-3; n = 3,757) were included. Gepotidacin achieved comparable microbiological success (RR = 1.10; 95% CI: 0.96-1.27; p = 0.17) and clinical cure rates (RR = 1.04; 95% CI: 0.95-1.13; p = 0.39) versus standard antibiotics. SAEs were rare and balanced (RR = 0.98; 95% CI: 0.37-2.58; p = 0.96). Overall risk of bias was low.Conclusions: Gepotidacin demonstrates non-inferior efficacy and comparable safety to standard antibiotics, supporting its role as a promising oral agent against resistant E. coli and N. gonorrhoeae.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"425-434"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Difficile to treat: advanced management strategies in difficult to treat Clostridioides difficile infections. 难辨梭菌的治疗：难辨梭菌感染的先进治疗策略。

IF 3.8 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-04-01 Epub Date: 2026-04-15 DOI: 10.1080/14787210.2026.2659725

Sahil Khanna, Patricia P Bloom

{"title":"Difficile to treat: advanced management strategies in difficult to treat Clostridioides difficile infections.","authors":"Sahil Khanna, Patricia P Bloom","doi":"10.1080/14787210.2026.2659725","DOIUrl":"10.1080/14787210.2026.2659725","url":null,"abstract":"Introduction: Clostridioides difficile infection (CDI) remains a leading cause of healthcare-associated infectious diarrhea, with a major burden driven by recurrences and severe or even fulminant disease in vulnerable hosts. The therapeutic landscape has shifted toward fidaxomicin-based antibiotic regimens and microbiota restoration strategies, including standardized microbiota-based products.Areas covered: Recent international guidelines, outcome studies, and pivotal trials focused on difficult-to-treat phenotypes such as refractory or fulminant CDI, multiply recurrent CDI, and CDI in high-risk populations (immunocompromised, inflammatory bowel disease, critical illness) were reviewed. A PubMed search was supplemented by hand-searching additional references, guidelines and regulatory documents. Evidence is summarized for optimized antibiotic regimens, bezlotoxumab, conventional fecal microbiota transplantation (FMT), FDA-approved microbiota-based products, and salvage strategies including intracolonic therapy and surgery.Expert opinion: Advanced CDI management is moving from repeated antibiotic cycling toward individualized recurrence prevention and microbiota restoration strategies. Implementation requires diagnostic stewardship, early recognition of recurrences, clear pathways for microbiota-based therapy access, and multidisciplinary care for fulminant infection. Over the next five years, standardized microbiota therapeutics and better risk tools should shift care toward earlier, more durable recurrence prevention.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"413-424"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Interplay between the arachidonic acid/cyclooxygenase 2/prostaglandin E₂ pathway and RNA viral infections. 花生四烯酸/环氧合酶2/前列腺素E2途径与RNA病毒感染的相互作用。

IF 3.8 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-04-01 Epub Date: 2026-04-29 DOI: 10.1080/14787210.2026.2665216

Areli J Navarro, Ignacio A Pasten-Ferrada, Felipe A Cancino, Hernán F Peñaloza, Alexis M Kalergis, Leandro J Carreño, Pablo A González

{"title":"Interplay between the arachidonic acid/cyclooxygenase 2/prostaglandin E2 pathway and RNA viral infections.","authors":"Areli J Navarro, Ignacio A Pasten-Ferrada, Felipe A Cancino, Hernán F Peñaloza, Alexis M Kalergis, Leandro J Carreño, Pablo A González","doi":"10.1080/14787210.2026.2665216","DOIUrl":"10.1080/14787210.2026.2665216","url":null,"abstract":"Introduction: Viruses manipulate cellular pathways to support their replication, often leading to inflammatory responses through the arachidonic acid (AA)/cyclooxygenase (COX)/prostaglandin E2 (PGE2) axis. Given the potential impact of this pathway on viral pathogenesis and disease severity, defining its role during infection warrants attention.Areas covered: This review examines the roles of COX-2 and its primary metabolite, PGE2, in RNA virus infections, highlighting their context-dependent effects on viral replication, pathogenesis, and host immunity. It also covers the therapeutic potential of selective COX-2 inhibitors over these processes. The review is based on articles retrieved during 2000-2025 through a systematic search in PubMed and the web.Expert opinion: Emerging evidence suggests that the AA/COX-2/PGE2 axis exerts significant, yet context-dependent antiviral effects during RNA virus infections. Critical gaps remain in understanding the tissue-specific effects of this pathway during RNA virus infections, including the contributions of COX-2-derived metabolites and their molecular mechanisms of action. In vivo studies and clinical trials are needed to evaluate the therapeutic potential of targeting the AA/COX-2/PGE2 axis, with available safe COX-2-inhibiting drugs approved for human use that allow such approaches. Knowledge derived from these assays could yield impactful therapeutic applications that significantly improve clinical outcomes in RNA virus infections.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"393-412"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Non-prescription antibiotic dispensing and counseling practices in Iraqi community pharmacies: implications for antimicrobial stewardship and resistance containment. 伊拉克社区药房的非处方抗生素分发和咨询做法：对抗菌素管理和耐药性控制的影响。

IF 3.8 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-04-01 Epub Date: 2026-04-21 DOI: 10.1080/14787210.2026.2663104

Omeed Darweesh, Brian Godman, Amanj Kurdi

{"title":"Non-prescription antibiotic dispensing and counseling practices in Iraqi community pharmacies: implications for antimicrobial stewardship and resistance containment.","authors":"Omeed Darweesh, Brian Godman, Amanj Kurdi","doi":"10.1080/14787210.2026.2663104","DOIUrl":"10.1080/14787210.2026.2663104","url":null,"abstract":"Background: To assess the prevalence, characteristics, dispensing practices, and counseling behavior of non-prescription antibiotic dispensing among Iraqi community pharmacies to inform antimicrobial stewardship (AMS) policy.Research design and methods: A cross-sectional simulated client study was conducted among 696 pharmacies across five Iraqi provinces. Standardized scenarios of upper respiratory tract infection were used to evaluate dispensing behavior, counseling quality (defined as whether staff provided key counseling components including enquiry about symptoms, allergy status, dosage instructions, and treatment duration), and antibiotic class distribution according to the WHO-AWaRe framework. Data were analyzed using descriptive and multivariable logistic regression.Results: Antibiotics were dispensed without prescription in 80.6% (95%CI:77.6-83.5%) of the visits. Access antibiotics accounted for 60.8% (95%CI:56.9-65.0%) and Watch agents for 39.2% (95%CI:34.9-43.1%), with amoxicillin-(26.4%), amoxicillin-clavulanate-(30.7%), and azithromycin-(25.5%) most common. Counseling was poor; only 15% (95%CI:12.3-18.3%) of the providers asked any clinical question and only 7.7% (95%CI:5.5-9.9%) enquired about allergy history. Non-pharmacist staff (nurses) were significantly more likely to dispense antibiotics without prescription compared with pharmacists (OR = 5.7; 95%CI:3.2-10.1).Conclusions: Non-prescription antibiotic dispensing and minimal counseling remain widespread in Iraqi pharmacies. Effective AMS in Iraq will require phased, system-level approaches, including strengthened regulatory enforcement, workforce support addressing all pharmacy personnel, and integration of community pharmacies into national AMR strategies.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"435-448"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0