Frontiers in Anti-infective Agents

Ocular drug targeting is one of the most interesting and challenging research topics due to the presence of natural barriers of the eye that attract pharmaceutical technologists. It is important to treat ocular infections, which are frequently encountered and affect people of all ages, in order to protect the integrity of the eye. For this reason, anti-infective agents used in the treatment of ocular infections are frequently the subject of ocular drug delivery system studies. The ocular bioavailability of anti-infective agents is also increased, thanks to micro and nano-carriers, where the dose strength of drugs and frequency of administration can be reduced. On the other hand, the fact that there are products approved by the USFDA among these delivery systems which have completed clinical phase studies shows that these drug delivery systems are promising in the ocular field.

Anti-infective agents are effective for controlling infectious diseases by killing or inhibiting infectious organisms. Anti-infective agent encompasses antibiotics, antifungal agents and antiviral agents, etc. In this category, vaccines are major contributors in recent years to preventing infectious diseases. The emergence of COVID-19 (COronaVIrus Disease 2019) pandemic has caused a resurgence of interest in finding new vaccines. The vaccines are generally classified into conventional vaccines and recombinant vaccines. In this context, the recent development of Vaccines for SARS-CoV (Severe Acute Respiratory Syndrome Coronavirus) has to be focussed. SARS-CoV is a human virus that comes under the order of Nidovirales and the family of Coronaviridae. This virus primarily causes respiratory diseases by targeting ACE-2 (angiotensin-converting enzyme 2) receptor. This virus is categorized into SARSCoV- 1 and SARS-CoV-2 (COVID-19). In this essence, the contents embrace the various aspects regarding the common vaccine development pipeline, importance of vaccination for prevention of infectious diseases, types of vaccine production methods that are implemented for SARS-CoV virus categories, potential targets for SARS-CoV vaccines, difficulties or feasibilities involved in vaccine production, phases accomplished in vaccine production and involvement of vaccines in addressing the global pandemic. In conclusion, this chapter confers the outline of vaccine progression marked up-to-date for SARS-CoV.

The increase in antibiotic resistance is an imminent and mainly silent threat, which would lead to an unprecedented situation with multivariable implications. It is challenging to solve due to having nuances in the regulatory, health-related, financial, and administrative aspects. The skin is one of the most common areas where antimicrobial-resistant infections develop; such is the case with MRSA (Methicillin- Resistant Staphylococcus aureus), which is capable of causing deep painful boils. Besides, the chronic wounds, whose healing processes become aberrant, add complexity, yet these occur with features, such as aberrant cellular profile, persistent inflammation, and the formation of biofilms. The former issues make crucial the use of non-antibiotic antimicrobial agents, such as topical antiseptics for their treatment. In the present writing, we have introduced an innovative formula with relatively familiar ingredients to most people. One of those compounds is the potassium permanganate, a strong oxidative, astringent, and antimicrobial agent. This chapter consists of five sections: (1) the first section presents a general review of the antibiotics, their types and mechanism of action, and resistance caused in response to them from bacteria; this section also describes causes for this resistance, the bacterial strategies to achieve it, and possible solutions; (2) the second section highlights the approach to healing processes both acute and chronic, exploring the stages of the former, and both the abnormal features and possible therapies for the latter; (3) the third section discusses the non-antibiotic antimicrobial agents and the antiseptics in general, and then a brief description is provided for the healing properties of each of the component of Vikut®, and finally, hypotheses for its performance have been proposed; (4) the fourth section presents the results of the clinical cases using the potassium permanganate-based formula obtained by healthcare professionals in the treatment of both chronic and nonchronic wounds. Two main subsections have discussed wound treatment using Vikut® formula; (4.1) the first subsection presents a 21 days-long comparative analysis between the usual treatment (neutral pH super-oxidation solutions) and the potassium permanganate-based formula for diabetic patients with chronic, 3 month-duration, Wagner I & II ulcers (average area 5-6cm2), where potassium permanganate-based formula has shown an average percentage reduction of 73% and a percentage of patients with area reduction greater or equal to 50% of 86%, in contrast to the usual treatment with ratios below 40% and 40% respectively, and (4.2) the second subsection is an exposition with respect to the clinical cases of both chronic and non-chronic wounds of different natures making use of the potassium permanganate-based formula; and (5) finally, the fifth section demonstrates an economical study performed on the public health condition in Mexico where several topical treatments are compared including the Vikut® formula, showing it as a viable option in terms of both the cost per se and the wound-reductive effect, which can be interpreted with respect to both time and resources available for the treatment of other afflictions in the public health domain.

With the increase in the prevalence of chronic microbial infections and disorders associated with it, the incidence of antibiotic resistance among microorganisms has continued to rise. Due to this, resistance against conventional antibiotic therapy is also increasing, which has become a public health concern. It is necessary to make clinical trials better, improve the idea of research plans, and take into account the cutting-edge drug safety approaches for the development of antiinfective drugs. In this regard, biofilm development and quorum sensing associated virulence approach appears insufficient for the use of traditional antibiotics. The exploitation of different synthetic and natural compounds for their efficacy in combating microbial infections associated with QS has been done, but the compatibility and availability of these compounds limit their applications. Therefore, for the diagnosis and treatment of infectious diseases, particularly resistant to antibiotics, nanotechnological interventions offer various biomedical applications. Nanomaterials exhibit intrinsic anti-infective properties towards the MDR phenomenon and also can be used as carriers for targeted and site-specific delivery of potential drugs.

SARS-CoV-2, a newly identified coronavirus, causes the coronavirus disease of 2019 usually termed COVID-19 and is considered a pandemic and spreads by zoonotic transmission. The human coronavirus SARS CoV2 is similar to SARS CoV and MERS CoV both belonging to the β-coronavirus group but the mild differences between them influence the greater pathogenicity in SARS-CoV-2. The virus produces 4 clinically important proteins that are responsible for host-cell receptor attachment, suppression of host gene expression, and replication leading to multiple infections. It is much important to get insights into the essence of the virus and the virus-induced disease. Since the viruses have the ability to mutate quickly, the discovery of drugs against the virus is challenging. However, many scientists and researchers across the world are working hopefully to discover drugs or vaccines to slow down or stop the replication process of the virus. The repurposing of existing drugs has gained importance as it reduces time and cost-effectiveness during the drugdiscovery process and development. In this chapter, we have highlighted the on-going researches on drugs against SARS-CoV-2 which are under various phases of a clinical trial. These include various FDA-approved (Food and Drug Administration) inhibitors such as protease inhibitors, polymerase inhibitors, antimalarial drugs, rheumatoid drugs, and lipid- lowering statins.

The purpose of this study is to develop an efficient therapy of combination antibiotics for the treatment of sexually transmitted infections. The best-preferred combination of drugs Cefixime trihydrate and Ofloxacin was selected to prepare bilayer tablets. This combination work against several genito-urinary tract infections. The Bilayer tablet was prepared in order to tailor the release of the drug to maintain the peak plasma level of the drug. It contains Cefixime trihydrate as a quick release layer and Ofloxacin as an extended-release layer. In this tablet, super disintegrant was used for the rapid release of the Cefixime layer, whereas HPMC was used to prolong the release of the ofloxacin layer. Drug release study suggests that there is a complete release of Cefixime within 30 minutes followed by the simultaneous release of ofloxacin, which was extended up to 24 hours. Current research reveals that Cefixime trihydrate and ofloxacin bilayer have been successfully developed for use in combating sexually transmitted infections.