Multiple Drug Resistance: An Up-Date
Pp. 112-137 (26)
Ruxandra Pirvulescu, Mihaela Oana Romanitan and Alina Popa- Cherecheanu
Multiple Drug Resistance (MDR) is acquired by bacteria, viruses, fungi,
parasites and malignant tumours at interaction with antibiotics/medicines of old or new
generation. Here is presented an up-date of MDR reported on bacteria, viruses, fungi,
parasites and tumors, in this last field with emphasis on ophthalmology and
neurology/neurosurgery. Multidrug resistant organisms exhibit in vitro resistance to
one or more antimicrobial agents. One cause is the increasing use and misuse of
antibiotics on humans and animals. Whereas particular bacteria are naturally resistant
to some antibiotics, MDR occurs in other cases by accumulation of resistant plasmids
and/or of genes, each gene determining resistance to a specific agent. The action of
efflux pumps able to pump out more than one drug type is also a possible mechanism
involved in MDR. In general, MDR is the most important “process” by which tumors
acquire resistance to drugs during chemotherapy. Bacterial resistance to antibiotics
used in ophthalmology has been reported since more than 10 years showing that several
bacteria resistant to antibiotics were found in isolates from ocular infections. In
neuroscience, development of new therapies to treat brain infections is more difficult.
The most important cause of failure in developing new drugs for treating brain diseases
is the existence and action of blood brain barrier (BBB). Brain tumors have usually
poor prognosis and due to BBB, drug delivery to brain tumors is difficult. Some studies
mention that BBB is involved in drug restriction to different brain neoplasias. The
chapter concludes about the need to improve the arsenal conceived to overcome MDR
acquired by different biological targets.
Blood brain barrier, Cancer, Chemotherapy, Chemoresistance, DNA,
Efflux pumps, Fungi, Gram-negative bacteria, Gram-positive bacteria, Hepatitis
viruses, Herpes viruses, HIV, Malaria, Multiple drug resistance, Ophthalmology,
Plasmodia species, Pseudomonas aeruginosa, Saccharomyces cerevisiae,
Staphylococcus aureus (MRSA), Tuberculosis.
University of Medicine and Pharmacy “Carol Davila”, Emergency University Hospital, Ophthalmology Clinic, Bucharest, Romania.