Abstract：
Antibiotic-resistant bacteria are currently an important public health concern posing a serious threat due to their resistance to the current arsenal of antibiotics. Uropathogens Escherichia coli (UPEC), Proteus mirabilis, Klebsiella pneumoniae and Enterococcus faecalis, antibiotic-resistant gram-negative bacteria, cause serious cases of prolonged UTIs, increasing healthcare costs and potentially even leading to the death of an affected patient. This review discusses current knowledge about the increasing resistance to currently recommended antibiotics for UTI therapy, as well as novel therapeutic options. Traditional antibiotics are still a part of the therapy guidelines for UTIs, although they are often not effective and have serious side effects. Hence, novel drugs are being developed, such as combinations of β-lactam antibiotics with cephalosporins and carbapenems. Siderophoric cephalosporins, such as cefiderocol, have shown potential in the treatment of individuals with significant gram-negative bacterial infections, as well as aminoglycosides, fluoroquinolones and tetracyclines that are also undergoing clinical trials. The use of cranberry and probiotics is another potential curative and preventive method that has shown antimicrobial and anti-inflammatory effects. However, further studies are needed to assess the efficacy and safety of probiotics containing cranberry extract for UTI prevention and treatment. An emerging novel approach for UTI treatment is the use of immuno-prophylactic vaccines, as well as different nanotechnology solutions such as nanoparticles (NP). NP have the potential to be used as delivery systems for drugs to specific targets. Furthermore, nanotechnology could enable the development of nano antibiotics with improved features by the application of different NPs in their structure, such as gold and copper NPs. However, further high-quality research is required for the synthesis and testing of these novel molecules, such as safety evaluation and pharmacovigilance.
摘要：
抗生素抗性细菌目前是一个重要的公共卫生问题，由于它们对目前的抗生素库具有抗性，因此构成了严重威胁。尿致病菌大肠杆菌（UPEC），变形杆菌,肺炎克雷伯菌和粪肠球菌，耐抗生素革兰氏阴性菌，导致严重的长期UTI病例，增加医疗保健成本，甚至可能导致受影响的患者死亡。这篇综述讨论了关于对目前推荐的UTI治疗抗生素的耐药性增加的最新知识，以及新颖的治疗选择。传统抗生素仍然是UTI治疗指南的一部分，尽管它们通常无效且有严重的副作用。因此，新药正在研发中，例如β-内酰胺抗生素与头孢菌素和碳青霉烯类抗生素的组合。铁皮头孢菌素，比如头孢得洛,在治疗患有显著革兰氏阴性细菌感染的个体方面显示出潜力，以及氨基糖苷类,氟喹诺酮类药物和四环素类药物也正在接受临床试验。蔓越莓和益生菌的使用是另一种潜在的治疗和预防方法，已显示出抗菌和抗炎作用。然而,需要进一步的研究来评估含蔓越莓提取物的益生菌预防和治疗UTI的有效性和安全性.一种新兴的UTI治疗新方法是使用免疫预防疫苗，以及不同的纳米技术解决方案，如纳米粒子（纳米粒子）。纳米颗粒具有用作药物到特定靶标的递送系统的潜力。此外，纳米技术可以通过在其结构中应用不同的纳米颗粒来开发具有改进特征的纳米抗生素，如金和铜纳米颗粒。然而,这些新分子的合成和测试需要进一步的高质量研究，如安全性评价和药物警戒。
