Antibiotics-Basel最新文献

{"title":"Local Vancomycin Application Reduces Periprosthetic Joint Infections in Oncologic Megaprosthetic Reconstruction: A Retrospective Cohort Study.","authors":"Andreas G Tsantes, Dimitrios V Papadopoulos, Stavros Goumenos, Petros Ioannou, Nikolaos Stavropoulos, Eleni Petrou, Ioannis G Trikoupis, Christos Koutserimpas, Alexandra Mpakosi, Vasileios A Kontogeorgakos, Stefanos Bonovas, Panayiotis J Papagelopoulos, Athanasios Tsakris, Argirios E Tsantes","doi":"10.3390/antibiotics14090952","DOIUrl":"10.3390/antibiotics14090952","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Periprosthetic joint infections (PJIs) represent a serious complication following musculoskeletal tumor resection and megaprosthetic reconstruction. Local antibiotic administration may reduce infection risk by achieving high local drug concentrations. The aim of this study was to evaluate whether local vancomycin powder reduces postoperative periprosthetic infections in bone tumor surgeries involving megaprostheses. <b>Methods:</b> This retrospective cohort study included 276 patients who underwent bone tumor resection and megaprosthetic reconstruction. Study subjects were divided into two groups: the control group (n = 142) that received standard perioperative intravenous antibiotics, and the vancomycin group (n = 134) that received an additional 1 g of vancomycin powder locally at wound closure. Periprosthetic joint infections were defined using the 2018 International Consensus Meeting (ICM) criteria and monitored for 2 years. A multivariable competing risks regression model was used to assess the independent effect of local vancomycin on infection risk. <b>Results:</b> Periprosthetic joint infections occurred in 28 patients in the control group (19.7%) vs. eight patients in the vancomycin group (5.9%, <i>p</i> = 0.001). The most frequently isolated pathogens were coagulase-negative staphylococci (52.7%), followed by <i>Staphylococcus aureus</i> (22.2%). Among infected patients in the vancomycin group, only two had Gram-positive infections, suggesting efficacy against staphylococcal PJIs. The multivariable regression confirmed a significantly lower risk of infection in the vancomycin group (hazard ratio [HR]: 0.40, 95% confidence interval [CI]: 0.16-0.95, <i>p</i> = 0.040), while pelvic tumors were associated with a higher infection risk (HR: 5.82, <i>p</i> < 0.001). <b>Conclusions:</b> Our results indicate that local vancomycin may reduce periprosthetic infection rates in oncologic megaprosthetic reconstruction without added complications. Randomized studies are warranted to confirm these findings and refine dosing strategies.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climate Change and AMR: Interconnected Threats and One Health Solutions.","authors":"Bilal Aslam, Sulaiman F Aljasir","doi":"10.3390/antibiotics14090946","DOIUrl":"10.3390/antibiotics14090946","url":null,"abstract":"<p><p>Climate change is a significant driver of antimicrobial resistance (AMR) and infectious disease dynamics, presenting urgent and interconnected global health challenges. Rising temperatures, ecosystem alterations, and extreme weather events amplify the global spread of resistant pathogens, zoonotic infections, and vector-borne diseases. These impacts disproportionately affect low- and middle-income countries (LMICs), escalating healthcare costs and straining limited infrastructure. A critical characteristic of bacterial resistance is that it often does not incur a fitness cost, underscoring the necessity of preventive strategies to mitigate climate-driven AMR emergence, rather than relying on reactive treatments after resistance is established. Climate change accelerates AMR primarily by increasing the prevalence of infectious diseases, which in turn drive higher antibiotic use and select resistance. The socioeconomic consequences are particularly severe in LMICs, where high climate vulnerability converges with weaker health systems. Pandemic-related disruptions provided key insights into environmental dynamics, with notable temporary reductions in nitrogen dioxide (NO₂) emissions, i.e., 20-30% in China, Italy, France, and Spain, and approximately 30% in the USA, which highlights the responsiveness of ecosystems to human activity. Unlike prior reviews that treated AMR and climate change as separate issues, this article integrates mechanistic evidence, epidemiological insights, and global strategies to provide a comprehensive One Health framework addressing these synergistic threats. We conclude that AMR and climate change are interlinked crises requiring urgent, integrated interventions. The quadripartite (FAO, UNEP, WHO, WOAH) provides a crucial framework for the coordinated cross-sectoral strategies, strengthened surveillance, and robust antibiotic stewardship required to mitigate this dual threat and safeguard global health security.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phage Resistance Modulates <i>Escherichia coli</i> B Response to Metal-Based Antimicrobials.","authors":"Franklin C Ezeanowai, Akamu J Ewunkem, Ugonna C Morikwe, Larisa C Kiki, Lindsey W McGee, Joseph L Graves, Liesl K Jeffers-Francis","doi":"10.3390/antibiotics14090942","DOIUrl":"10.3390/antibiotics14090942","url":null,"abstract":"<p><p><b>Background/Objective</b>: The rise of multidrug-resistant bacteria underscores the urgent need for alternative antimicrobial strategies. Metal-based compounds and bacteriophage (phage) therapy have emerged as promising candidates, but the evolutionary trade-offs associated with these selective pressures and their combination remain poorly understood. This study aimed to investigate how prior exposure to T4 phage influences <i>Escherichia coli</i> B's subsequent adaptation to iron (III) stress and to assess the resulting phenotypic and genomic signatures of dual resistance. <b>Method:</b> In this study, we performed experimental evolution using <i>Escherichia coli</i> B to investigate adaptive responses under four conditions: control (LB broth), T4 phage-only, iron (III) sulfate-only, and sequential phage followed by iron (III) exposure. Each treatment consisted of ten independently evolved populations (biological replicates), all derived from a common ancestral strain and passaged daily for 35 days. Phage resistance evolved rapidly, with complete resistance observed within 24 h of exposure. <b>Results:</b> In contrast, iron-selected populations evolved tolerance to high iron concentrations (1000-1750 mg/L) over time at a cost to resistance in other metals (gallium and iron (II) and antibiotics (tetracycline). Notably, prior phage exposure altered these outcomes: phage/iron-selected populations retained phage resistance and iron tolerance but showed diminished resistance to iron (II) and distinct antibiotic sensitivity profiles. Whole-genome sequencing revealed stressor-specific adaptations: large deletions in phage receptor-related genes (<i>waaA</i> and <i>waaG</i>) under phage pressure, and selective sweeps in iron-adapted populations affecting regulatory and membrane-associated genes (<i>qseB</i>, <i>basR</i>, <i>aroK</i>, <i>fieF</i>, <i>rseB</i>, and <i>cpxP</i>). <b>Conclusions:</b> These results demonstrate that the sequence of environmental stressors significantly shapes phenotypic and genetic resistance outcomes. Our findings highlight the importance of fitness epistasis and historical contingency in microbial adaptation, with implications for the design of evolution-informed combination therapies.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"α-Amylase-Mediated Antibiotic Degradation and Sequestration in <i>Pseudomonas aeruginosa</i> Biofilm Therapy.","authors":"Robert K Murray, Allison E Martin, Sarah Zipkowitz, Nusrat Jahan, Tony D Davis, Whitni K Redman","doi":"10.3390/antibiotics14090941","DOIUrl":"10.3390/antibiotics14090941","url":null,"abstract":"<p><strong>Background: </strong>As of 2022, 80% of all documented microbial infections are biofilm-associated: communities of microorganisms adhered to a surface and enclosed in a complex extracellular polymeric substance (EPS). The EPS acts as a physical barrier protecting the bacteria from antimicrobial agents and host immune responses. To combat this hurdle, the application of glycoside hydrolases (GH) has been investigated due to their ability to cleave particular structural polysaccharides within the EPS, thus breaking down the protective barrier and improving antibiotic clearance. While various studies demonstrate the capacity of GHs to improve antibiotic efficacy against biofilms in combination, there is clear differential success between these treatments depending on the GH and antibiotic chosen. Due to the overlap of GH targets and antibiotic structures, it is imperative to ensure that the antibiotics in combinatorial treatments are not degraded by the GH.</p><p><strong>Methods: </strong>This study aimed to screen the GH α-amylase produced from <i>Aspergillus oryzae</i> (AO) and <i>Bacillus subtilis</i> (BS), combined with various antibiotics from different classes, charges, and mode of actions by determining MICs. against the bacterium <i>Pseudomonas aeruginosa</i> (PA) of 6 antibiotics with or without α-amylase and treat 2-day PA biofilms with antibiotics with or without GHs. Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS) stability assays and Differential Scanning Fluorimetry (DSF) were conducted to determine antibiotic and GH degradation as well as antibiotic sequestration.</p><p><strong>Results: </strong>Increased MICs in the presence of GHs as well as decreased antibiotic clearance against 2-day biofilms were suggestive of antibiotic degradation. LC-MS/MS stability assays of tetracycline and ciprofloxacin in the presence and absence of α-amylase further demonstrated the α-amylase-mediated antibiotic sequestration. Differential scanning fluorimetry (DSF) assays confirmed α-amylase-antibiotic interactions.</p><p><strong>Conclusions: </strong>This study suggests that α-amylase is capable of degrading and sequestering a variety of antibiotics, and the degree to which these phenomena occur varies depending upon the source of the GH. As a potential treatment for biofilm-associated infections, it is imperative that the GH + antibiotic combinations are determined compatible prior to clinical use.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial and Antibiofilm Activities of Some Antioxidant 3,4-Dihydroxyphenyl-Thiazole-Coumarin Hybrid Compounds: In Silico and In Vitro Evaluation.","authors":"Daniel Ungureanu, Gabriel Marc, Mihaela Niculina Duma, Radu Tamaian, Dan Cristian Vodnar, Brîndușa Tiperciuc, Cristina Moldovan, Ioana Ionuț, Anca Stana, Ovidiu Oniga","doi":"10.3390/antibiotics14090943","DOIUrl":"10.3390/antibiotics14090943","url":null,"abstract":"<p><p><b>Background/Objectives</b>: In this study, we aimed to investigate the antimicrobial and antibiofilm activity of seven hydroxyphenyl-thiazolyl-coumarin hybrid compounds with antioxidant properties (<b>1a</b>-<b>g</b>), previously reported by our group. <b>Methods</b>: The compounds were evaluated in vitro through MIC, MBC, and MFC determinations, and percentage of biofilm (BF) inhibition and in silico, respectively, through molecular docking, molecular dynamics simulations, and ADMETox prediction. <b>Results</b>: All compounds showed antibacterial and antifungal activities. In terms of antibacterial activity, all the compounds were active on <i>Pseudomonas aeruginosa</i> (MICs = 15.62-31.25 μg/mL), <i>Enterococcus faecalis</i> (MICs = 15.62-31.25 μg/mL), and <i>Staphylococcus aureus</i> (MICs = 62.5-125 μg/mL). Regarding the antifungal activity, the effect against <i>Candida albicans</i> was similar to fluconazole (MIC = 15.62 μg/mL), compounds <b>1b</b> and <b>1g</b> being the most active against <i>Aspergillus brasiliensis</i> (MIC = 15.62 μg/mL). Furthermore, all compounds were both bactericidal and fungicidal. Regarding the antibiofilm activity, compounds <b>1d</b>-<b>g</b> showed superior <i>P. aeruginosa</i> BF inhibition compared to gentamicin. The in vitro results for the antibacterial activity were well correlated with the observations drawn in the molecular docking studies, where the best binding affinities (BAs) were observed against <i>P. aeruginosa</i> PAO1 GyrB subunit, and the molecular dynamics simulations confirmed the antibacterial mechanism of compounds <b>1a, 1b</b>, <b>1d</b>, <b>1f,</b> and <b>1g</b> through GyrB subunit inhibition. Regarding the antifungal activity, all compounds showed better BAs than fluconazole against CYP51 in all instances. ADMETox predictions concluded that all the compounds could have low gastrointestinal absorption and reduced risk of pharmacokinetic interactions. <b>Conclusions</b>: The investigated compounds bring novelty into the actual research due to their dual antibacterial and antibiofilm activity against biofilm-associated <i>P. aeruginosa</i> infections.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic Characterization of Antimicrobial Resistance and Evolution Mechanism of Bacteria.","authors":"Daniel Gyamfi Amoako, Linda Antionette Bester","doi":"10.3390/antibiotics14090945","DOIUrl":"10.3390/antibiotics14090945","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) continues to rank among the most pressing global health threats, frequently referred to as a \"<i>silent pandemic</i>\" that undermines decades of progress in infectious disease control while jeopardizing both human and animal health [...].</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whole-Genome Sequencing and Antibiotic Resistance Profiling of <i>Helicobacter pylori</i> Isolates from a Tertiary Hospital in Southern Thailand.","authors":"Chonticha Romyasamit, Apichat Kaewdech, Pimsiri Sripongpun, Naichaya Chamroonkul, Komwit Surachat, Sirikan Suwannasin, Yosita Leepromma, Morteza Saki, Maseetoh Samaeng, Phoomjai Sornsenee","doi":"10.3390/antibiotics14090944","DOIUrl":"10.3390/antibiotics14090944","url":null,"abstract":"<p><p><b>Background</b>: <i>Helicobacter pylori</i> is associated with a wide range of gastroduodenal diseases, including chronic gastritis, peptic ulcer disease, and gastric cancer. Eradication efforts are challenged by increasing antimicrobial resistance rates, particularly in Southeast Asia. We sequenced the whole genomes of clinical <i>H. pylori</i> isolates from Southern Thailand to elucidate their resistance profiles, virulence determinants, and evolutionary relationships. <b>Methods</b>: Three clinical <i>H. pylori</i> isolates (004, 117, and 189) were subjected to whole-genome sequencing, phenotypic antimicrobial susceptibility testing, and comparative genomic analyses. <b>Results</b>: All strains exhibited high-level resistance to metronidazole. Additionally, <i>H. pylori</i> 117 was resistant to both amoxicillin and levofloxacin, classifying it as multidrug-resistant. Genomic analysis revealed mutations in <i>rdxA</i>, <i>frxA</i>, and <i>rpoB</i>, as well as in penicillin-binding protein genes (<i>pbp2</i> and <i>pbp3</i>), supporting the phenotypic findings. While all isolates harboured clarithromycin resistance mutations (A2142G and A2143G in the 23S rRNA gene), they were phenotypically susceptible, highlighting a potential discordance that requires further investigation. Virulence gene profiling identified 115-118 conserved genes per strain, including <i>cagA</i>, <i>vacA</i>, <i>oipA</i>, <i>babA</i>, and flagellar, urease, and lipopolysaccharide biosynthesis genes. Phylogenetic analysis using core-genome single-nucleotide polymorphisms demonstrated that these strains formed a distinct Southern Thai monophyletic clade, suggesting localised clonal expansion driven by regional selective pressures. <b>Conclusions</b>: Region-specific surveillance strategies and treatment guidelines are urgently needed in Thailand. The combination of high-risk virulence genes and rising antimicrobial resistance in <i>H. pylori</i> strains necessitates tailored therapeutic approaches, the integration of genomic surveillance into clinical diagnostics, and expanded studies linking genotype to clinical outcomes in diverse populations.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Culture: Real-Time PCR Performance in Detecting Causative Pathogens and Key Antibiotic Resistance Genes in Hospital-Acquired Pneumonia.","authors":"Lana Hani Abu Khadija, Shatha M Alomari, Ahmad R Alsayed, Heba A Khader, Andi Dian Permana, Luai Z Hasoun, Manar Saleh Zraikat, Walaa Ashran, Malek Zihlif","doi":"10.3390/antibiotics14090937","DOIUrl":"10.3390/antibiotics14090937","url":null,"abstract":"<p><p><b>Introduction:</b> The rise in hospital-acquired pneumonia (HAP) due to antibiotic-resistant bacteria is increasing morbidity, mortality, and inappropriate empirical antibiotic use. This prospective research aimed to evaluate the performance of a real-time polymerase chain reaction (PCR) assay for detecting causative microorganisms and antibiotic-resistance genes from respiratory specimens compared to traditional methods. Additionally, we aimed to determine the molecular epidemiology of antibiotic resistance genes among HAP patients at The University of Jordan hospital. <b>Methods:</b> Lower respiratory tract samples were collected from HAP patients, including those with ventilator-associated pneumonia (VAP), between May 2024 and October 2024. Clinical data from the medical files were used to collect and analyze demographic and clinical information, including clinical outcomes. Real-time PCR was run to detect causative microbes and antibiotic resistance genes. <b>Results:</b> Among 83 HAP patients (median age 63, 61.45% male), 48.15% died. Culture identified <i>Klebsiella</i> (25.53%), <i>Acinetobacter</i> (22.34%), and <i>Candida</i> (24.47%) as the most common pathogens, while qPCR showed higher detection rates, including for <i>A. baumannii</i> (62.20%, <i>p</i> = 0.02) and <i>K. pneumoniae</i> (45.12%, <i>p</i> < 0.001). Carbapenem resistance was high; <i>A. baumannii</i> showed 100% resistance to most antibiotics except colistin (92.31%). The resistance genes <i>ndm</i> (60%) and <i>oxa-48</i> (58.46%) were frequently detected and significantly associated with phenotypic resistance (<i>p</i> < 0.001). The qPCR identified resistance genes in all carbapenem-resistant cases. No gene significantly predicted mortality. <b>Conclusions:</b> Real-time PCR diagnostic technique combined with epidemiology of antibiotic resistance genes data may be a rapid and effective tool to improve HAP management. Large, multicenter studies are needed in the future to validate the performance of real-time PCR in HAP diagnosis, and appropriate management is also required.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Literacy and Interventions on Antibiotics Use and AMR in Younger Generations in High-Income Countries-A Systematic Review.","authors":"Katja Molan, Anamarija Zore, Nevenka Kregar Velikonja","doi":"10.3390/antibiotics14090940","DOIUrl":"10.3390/antibiotics14090940","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) is a growing threat to global health, accelerated by the widespread inappropriate use of antibiotics. Although educational initiatives have been launched worldwide, there is little evidence on how younger generations in high-income countries (HICs) understand and address AMR. Addressing the AMR crisis requires proactive education of younger generations, including children, adolescents, and young adults, who will shape future healthcare practices. This review analyzes existing research on AMR literacy among these age groups in HICs, as knowledge gaps and risky behaviors persist even in HICs, despite their strong education and health infrastructures. The purpose of this review is to examine the knowledge, attitudes, and behaviors related to antibiotic use and antibiotic resistance in younger generations while identifying effective educational interventions.</p><p><strong>Methods: </strong>We performed a comprehensive literature search in PubMed until June 2025, followed by AI-assisted screening (Claude 4.0 Sonnet) and a manual review. The search strategy combined terms from the areas of health literacy, antibiotics, antibiotic resistance/AMR, and young populations. Studies in HICs that examined the younger generation's knowledge about antibiotics and AMR, analyzed their attitudes or behavior toward them, or evaluated relevant educational interventions were included. Data were synthesized thematically across all included studies.</p><p><strong>Results: </strong>Nineteen studies from 11 HICs were included, including thirteen cross-sectional surveys and six educational intervention studies. The results showed that misconceptions about how antibiotics work are still very common. Several of those asked (22-80%) incorrectly stated that resistance develops in the human body and not in bacteria. Many (26-77%) mistakenly agreed with the statement that antibiotics treat viral infections. Concerning behaviors included high rates of self-medication, non-adherence to treatment, and unsafe storage practices. Several authors propose an amendment of curricula. Educational interventions, particularly gamification and peer education approaches, showed improvements in knowledge and sustained learning outcomes.</p><p><strong>Conclusions: </strong>Knowledge of AMR among young people in HICs is still inadequate, despite educational advantages. Most existing studies focus on college students, while children and adolescents, crucial groups for early prevention, are underrepresented. Targeted, age-appropriate education employing interactive methods represents an evidence-based strategy to improve antibiotic use behavior and support global AMR control efforts.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising Meropenem and Piperacillin Dosing in Patients Undergoing Extracorporeal Membrane Oxygenation Without Renal Dysfunction (MEPIMEX).","authors":"Mar Ronda, M Paz Fuset, Erika Esteve-Pitarch, Josep Llop, Victor Daniel Gumucio-Sanguino, Evelyn Shaw, Daniel Marco Mula, Kristel Maisterra-Santos, Joan Sabater, Xose L Pérez, Sara Cobo-Sacristan, Raül Rigo, Fe Tubau, Jordi Carratalà, Helena Colom-Codina, Ariadna Padullés","doi":"10.3390/antibiotics14090939","DOIUrl":"10.3390/antibiotics14090939","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Antibiotic pharmacokinetics (PK) and pharmacodynamics (PD) are altered during extracorporeal membrane oxygenation (ECMO). Meropenem and piperacillin are among the most commonly prescribed antibiotics for infections in this population. However, guidance on dosage adjustments in the ECMO setting remains limited. We aim to assess differences in meropenem and piperacillin concentrations achieved and identify the clinical, physiological, and mechanical factors influencing antibiotic exposure. <b>Methods</b>: This is a retrospective, single-centre, observational study comparing an ECMO cohort with a population control group from a prior study, without renal dysfunction. Demographic, clinical, PK/PD parameters, and ECMO-related data were analysed using univariate and generalised estimating equations. For both antimicrobials, the PK/PD target was set at 100%<i>f</i>T_>4xMIC. <b>Results</b>: A total of 130 critically ill patients were included: 18 in the ECMO group and 112 in the control group. The mean age was 65 years (23), 67% were male and 26.9% were classified as obese. For meropenem, renal function and ECMO support significantly influenced drug exposure, with PK/PD targets being achieved in 67% of measurements; in contrast, piperacillin exposure exhibited greater variability, primarily driven by renal function and mechanical ventilation. Notably, PK/PD targets for piperacillin were met in only 20% of measurements. <b>Conclusions</b>: Our findings highlight the considerable variability in β-lactam exposures and PK/PD target attainment in critically ill patients. This study underscores the importance of therapeutic drug monitoring and individualised dosing in attempts to improve antimicrobial efficacy and patient outcomes in this challenging setting.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}