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Fosfomycin and nitrofurantoin: classic antibiotics and perspectives

The Journal of Antibiotics volume 74, pages 547–558 (2021)Cite this article

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Abstract

Antibiotics are essential molecules for the treatment and prophylaxis of many infectious diseases. However, drugs that combat microbial infections can become a human health threat due to their high and often indiscriminate consumption, considered one of the factors of antimicrobial resistance (AMR) emergence. The AMR crisis, the decrease in new drug development by the pharmaceutical industry, and reduced economic incentives for research have all reduced the options for treating infections, and new strategies are necessary, including the return of some traditional but “forgotten” antibiotics. However, prescriptions for these older drugs including nitrofurantoin and oral fosfomycin, have been based on the results of pioneer studies, and the limited knowledge generated 50–70 years ago may not be enough. To avoid harming patients and further increasing multidrug resistance, systematic evaluation is required, mainly for the drugs prescribed for community-acquired infections, such as urinary tract infections (UTI). Therefore, this review has the objective of reporting the use of two classic drugs from the nitrofuran and phosphonic acid classes for UTI control nowadays. Furthermore, we also explore new approaches used for these antibiotics, including new combination regimes for spectral amplification, and the prospects for reducing bacterial resistance in the fight against bacteria responsible for UTI.

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Acknowledgements

The authors are grateful to the Fundação de Apoio à Pesquisa do Distrito Federal (FAPDF), the Fundação de Apoio ao Desenvolvimento do Ensino, Ciência e Tecnologia do Estado de Mato Grosso do Sul (FUNDECT), the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) and the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). This work did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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  1. Centro de Análises Proteômicas e Bioquímica, Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, Brazil

    Cristiane dos Santos & Octávio Luiz Franco

  2. Department of Biological and Health Sciences, Centro Universitário do Distrito Federal, Brasília, Brazil

    Lucas Souza dos Santos

  3. S-Inova Biotech, Pós-Graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande, Brazil

    Octávio Luiz Franco

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  1. Cristiane dos Santos
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Original draft preparation: Cristiane dos Santos. Wrote or contributed to the writing of manuscript: Cristiane dos Santos, Lucas Souza dos Santos and Octávio Luiz Franco.Supervision: Octávio Luiz Franco.

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Correspondence to Octávio Luiz Franco.

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dos Santos, C., dos Santos, L.S. & Franco, O.L. Fosfomycin and nitrofurantoin: classic antibiotics and perspectives. J Antibiot 74, 547–558 (2021). https://doi.org/10.1038/s41429-021-00444-z

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