To prevent healthcare-associated infections (HAI) is one of the global problems under the present conditions of development of a health care system and mankind as a whole [1]. According to the position of the World Health Organization (WHO), no one type of health facility in any country can claim to be free from the risk of HAI [2].
The frequency of HAI varies from 0.1 to 290 per 1000 patients, depending on the type of departments, the initial severity of the patient's condition, the level of aggression of the applied medical technologies and the degree of implementation of effective epidemiological measures. Patients experiencing a HAI had a significantly increased mortality risk (4-15-fold) and an increased length of hospital stay (threefold). According to the Centers for Disease Control and Prevention (CDC), every 17th case of an HAI is fatal, and the economic damage is about $ 30 million [3]
One of the reasons for the development of HAI is the growing number of antibiotic-resistant bacteria on the background of the irrational use of antibiotics. The causative agents of HAI are multi-drug resistant bacteria, which cause difficulties in the selection of treatment regimens in patients, threaten the development of incurable complications [4-5].
Bacteria develop resistance to antibacterial drugs through a variety of mechanisms4 that require a fresh approach to develop new bactericidals. The search for new antimicrobial agents or modifications in already existing ones to improve their antimicrobial activity becomes indispensable [6].
Increase the effectiveness of antibiotic therapy and reduce unwanted side effects is possible by creating nanoscale medicinal forms of antibacterial drugs. Nanoscale carriers of medicinal substances, and in particular nanoparticles, possess such unique physico-chemical properties as small sizes that allow them to deliver antibiotics to target cells, a high specific surface area, the possibility of surface functionalization for directional transport to target cells and / or organs [7]. In addition, controlled drug delivery technology offer numerous advantages compared to conventional dosage forms including improved efficacy, reduced toxicity, and improved patient compliance and convenience. Such systems often use synthetic polymers as carriers for the drugs [8].
Controlled release dosage forms provide continuous release of antibiotics at a predetermined rate and for a predetermined time. The majority of these formulations are designed for oral administration; however recently such devices have also been introduced for parenteral administration, ocular insertion and for transdermal application [8].
In this connection, controlled drug delivery system based on biodegradable polymers and antimicrobial drugs from the group of carbopenems are of particular interest. Since today, carbapenems are the most effective drugs for the treatment of HAI. The action of this group of antibiotics is characterized by a wide spectrum of activity.
References
- Akimkin V.G. Topical areas of researches in the nonspecific prevention of health care-associated infections / Akimkin V.G., Tutelyan A.V., Brusina E.B. // Epidemiology and Infectious Diseases. Current Items. – 2014. – № 2. – P. 40-44.
- WHO. Report on the burden of endemic health care-associated infection Worldwide. A systematic review of the literature. World Health Organization, 2011. 40 p. Available at: http://whqlibdoc.who.int/publications/2011/9789241501507_ eng.pdf
- Brusina E.B. Risk management of infections connected with providing medical aid (risk management) / Brusina E.B., Barbarash O.L. // Medical Almanac. – 2015. – Vol. 5 (40). – P. 22-25.
- Voroshilova T.M. Clinical and laboratory assessment of the effect of bisphosphonates and antiseptics on the resistance of gram-negative bacteria to carbapenems. Candidate’s thesis. St. Petersburg, 2017, 144 p. (in Russian)
- WHO. European strategic action plan on antibiotic resistance. World Health Organization, 2011. 10 p. Available at: http://www.euro.who.int/__data/assets/pdf_file/0008/147734/wd14E_AntibioticResistance_111380.pdf
- Singh R. Role of nanotechnology in combating multi-drug resistant bacteria / Singh R., Smitha M.S., Singh S.P. // J. Nanosci. Nanotechnol. – 2014. – Vol. 14 (7). – P. 4745-4756.
- Pacenko M.B. Perspectives of the application of nanotechnologies in treatment of bacterial infections (literature review) / Pacenko M.B., Balabanyan V.Y., Gelperina S.E. // Journal of new medical technologies. – 2018. – № 1. – P. 131-140.
- Gavasane A.J. Synthetic Biodegradable Polymers Used in Controlled Drug Delivery System: An Overview / Gavasane A.J., Pawar H.A. // Clinical Pharmacology & Biopharmaceutics. – 2014. – Vol. 3 (2). – P.1-7.