A combination of photodynamic therapy and antimicrobial compounds to treat skin and mucosal infections: a systematic review.
Journal
Photochemical & photobiological sciences : Official journal of the European Photochemistry Association and the European Society for Photobiology
ISSN: 1474-9092
Titre abrégé: Photochem Photobiol Sci
Pays: England
ID NLM: 101124451
Informations de publication
Date de publication:
15 May 2019
15 May 2019
Historique:
pubmed:
2
3
2019
medline:
10
7
2019
entrez:
2
3
2019
Statut:
ppublish
Résumé
Antimicrobial photodynamic therapy (aPDT) is a growing approach to treat skin and mucosal infections. Despite its effectiveness, investigators have explored whether aPDT can be further combined with antibiotics and antifungal drugs. To systematically assess the in vivo studies on the effectiveness of combinations of aPTD plus antimicrobials in the treatment of cutaneous and mucosal infections. Searches were performed in four databases (PubMed, EMBASE, Cochrane library databases, ClinicaTrials.gov) until July 2018. The pooled information was evaluated according to the PRISMA guidelines. 11 full-text articles were finally evaluated and included. The best aPDT combinations involved 5-aminolevulinic acid or phenothiazinium dye-based aPDT. In general, the combination shows benefits such as reducing treatment times, lowering drug dosages, decreasing drug toxicity, improving patient compliance and diminishing the risk of developing resistance. The mechanism of action may be that first aPDT damages the microbial cell wall or membrane, which allows better penetration of the antimicrobial drug. The number of studies was low, the protocols used were heterogeneous, and there was a lack of clinical trials. The additive or synergistic effect of aPDT combined with antimicrobials could be promising to manage skin and mucosal infections, helping to overcome the microbial drug resistance.
Sections du résumé
BACKGROUND
BACKGROUND
Antimicrobial photodynamic therapy (aPDT) is a growing approach to treat skin and mucosal infections. Despite its effectiveness, investigators have explored whether aPDT can be further combined with antibiotics and antifungal drugs.
OBJECTIVE
OBJECTIVE
To systematically assess the in vivo studies on the effectiveness of combinations of aPTD plus antimicrobials in the treatment of cutaneous and mucosal infections.
MATERIALS AND METHODS
METHODS
Searches were performed in four databases (PubMed, EMBASE, Cochrane library databases, ClinicaTrials.gov) until July 2018. The pooled information was evaluated according to the PRISMA guidelines.
RESULTS
RESULTS
11 full-text articles were finally evaluated and included. The best aPDT combinations involved 5-aminolevulinic acid or phenothiazinium dye-based aPDT. In general, the combination shows benefits such as reducing treatment times, lowering drug dosages, decreasing drug toxicity, improving patient compliance and diminishing the risk of developing resistance. The mechanism of action may be that first aPDT damages the microbial cell wall or membrane, which allows better penetration of the antimicrobial drug.
LIMITATIONS
CONCLUSIONS
The number of studies was low, the protocols used were heterogeneous, and there was a lack of clinical trials.
CONCLUSIONS
CONCLUSIONS
The additive or synergistic effect of aPDT combined with antimicrobials could be promising to manage skin and mucosal infections, helping to overcome the microbial drug resistance.
Identifiants
pubmed: 30821303
doi: 10.1039/c8pp00534f
pmc: PMC6520109
mid: NIHMS1016513
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1020-1029Subventions
Organisme : NIAID NIH HHS
ID : R01 AI050875
Pays : United States
Organisme : NIAID NIH HHS
ID : R21 AI121700
Pays : United States
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