Pharmacodynamic interaction of apotransferrin and anti-pseudomonal antibiotics against extensively drug-resistant Pseudomonas aeruginosa in a dynamic PK/PD model

Objectives: The rise of antibiotic resistance in clinical settings poses a major challenge. Apotransferrin has emerged as a potential non-traditional therapy for combating infections, potentially preventing resistance development while enhancing bactericidal effects. This study evaluated the efficac...

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Detalles Bibliográficos
Autores: Montero, Maria Milagro, Domene Ochoa, Sandra, Prim, Núria, López-Causapé, Carla, Echeverria-Esnal, Daniel, Sorli Redó, M. Luisa, Luque Pardos, Sònia, Padilla, Eduardo, Grau Cerrato, Santiago, Oliver, Antonio, Horcajada Gallego, Juan Pablo
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/70313
Acceso en línea:http://hdl.handle.net/10230/70313
http://dx.doi.org/10.1016/j.ijantimicag.2025.107477
Access Level:acceso abierto
Palabra clave:Apotranferrin
Ceftolozane/tazobactam
Chemostat
Pseudomonas aeruginosa
XDR
Descripción
Sumario:Objectives: The rise of antibiotic resistance in clinical settings poses a major challenge. Apotransferrin has emerged as a potential non-traditional therapy for combating infections, potentially preventing resistance development while enhancing bactericidal effects. This study evaluated the efficacy of apotransferrin combined with antipseudomonal antibiotics against extensively drug-resistant (XDR) Pseudomonas aeruginosa isolates. Methods: Twenty XDR P. aeruginosa clinical isolates were evaluated. Different apotransferrin concentrations were tested to determine the optimal in vitro concentration. Time-kill assays assessed the combined effects of apotransferrin with meropenem or ceftolozane/tazobactam (C/T). A chemostat model using four selected isolates validated the most effective combinations and monitored resistance emergence. Results: Apotransferrin monotherapy did not reduce bacterial load, but its combination with antipseudomonal antibiotics enhanced efficacy. Meropenem activity improved in 10/20 isolates, and C/T activity in 13/20 compared to antibiotic monotherapy. The chemostat model confirmed synergistic interactions between apotransferrin and C/T in two isolates, with additive effects in two others. This combination outperformed the most effective monotherapy in all isolates, with no emergence of new C/T-resistant strains. Conclusions: In conclusion, the combination of apotransferrin with C/T demonstrated superior in vitro efficacy against XDR P. aeruginosa isolates compared to either treatment alone. These findings suggest that apotransferrin could be a valuable adjunctive therapy, enhancing the antimicrobial effects of existing antibiotics and potentially extending their clinical utility.