In-vivo and In-vitro Therapeutic Perspectives in The Treatment of Burkholderia cepacia Complex Infections: A Review

Helmy, Noura AM; Basyony, Ahmed F; Tohamy, Sally TK; Zaki, Samar A

doi:10.21608/aijpms.2024.293015.1269

In-vivo and In-vitro Therapeutic Perspectives in The Treatment of Burkholderia cepacia Complex Infections: A Review

Document Type : Review Articles

Authors

¹ Department of Microbiology and Immunology, Faculty of Pharmacy, Egyptian Russian University, Badr City, Cairo, Egypt

² Department of Microbiology and Immunology, Faculty of Pharmacy (Girls), Al-Azhar University, Cairo, Egypt.

10.21608/aijpms.2024.293015.1269

Abstract

Burkholderia cepacia complex (Bcc) is an opportunistic, widespread pathogen. It first came out as a deadly lung infection with a high rate of morbidity and death among cystic fibrosis (CF) individuals. It is not only harmful to CF patients but is also thought to be a significant pathogen in other susceptible individuals. It has recently spread beyond the limits of CF and identified as a cause of healthcare-associated infections. Treatment of Bcc infections is considered a complex problem. It is a multi-drug-resistant microorganism that has different innate and acquired resistance mechanisms. Evaluating information retrieved from in-vitro and in-vivo studies was necessary to direct antibiotic therapy for infected patients. A review was conducted by searching the electronic database PubMed using MeSH terms in the search query aiming to retrieve more relevant results over the last ten years from 2015 to 2024. Data describing clinical diagnosis, different treatment regimens with durations, outcomes after treatment, and the antimicrobial susceptibilities were extracted from the in-vitro antimicrobial susceptibility investigations as well as in-vivo studies and then analyzed to address various aspects including the promising in-vivo therapy of Bcc infection in CF and non-CF patients, consistency between in-vivo studies and in-vitro susceptibility studies, and treatment duration. A total of 56 different studies were found eligible to be included in our review. Treatment mostly depended on combination therapy having ceftazidime either alone or combined with avibactam and meropenem as the most frequently used intravenous antibiotics while cotrimoxazole and fluoroquinolones were the most frequently used oral antibiotics.

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