TITLE:
Navigating the Third Frontier of Antimicrobial Therapy to Support Women’s Health
AUTHORS:
Emma Wittman, Neela Yar, Bryan Larsen
KEYWORDS:
Gynecologic Infection, Obstetric Infection, Antibiotic Therapy, Antimicrobial Resistance, Quiescent Microorganisms, Mechanisms
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.10 No.8,
August
6,
2020
ABSTRACT: This paper explores one of the underappreciated
reasons for lack of efficacy in certain cases of antimicrobial therapy, namely
the occurrence of a non-genetic resistance to antimicrobial drugs due to a
metabolic quiescence of microorganisms. This review has centered on those
microorganisms of particular importance in obstetrics and gynecology and
accordingly has reviewed the nature and extent of the persister phenotype in
relation to infectious agents affecting women’s health. We show how the
quiescent persister microbial phenotype represents the next significant issue
that could compromise successful antibiotic therapy. A brief history of
antimicrobial therapy is provided as context for the problem posed by the
persister phenotype. This review has been focused on the current literature having
relevance for physicians concerned with women’s health. The study of this
phenotype has led to increasing understanding of the molecular mechanisms for
this state which also provides ideas for rational development of drug
candidates to interdict these organisms in human disease and explores the
possibility of developing specifically targeted molecules to address
persisters, research on screening botanicals, existing drugs and chemicals to
discover novel approaches to the clinical consequence of microbial persisters.
Of interest in this review, is the return to naturally occurring botanical substances,
first to be used as anti-infectives, now being considered as possible agents
to address persister microorganisms. Overall this paper aims to provide information
tailored especially to the obstetrics and gynecology specialists.