Anti-infectives are a class of medicines that includes a wide range of drugs that selectively and directly attack invasive agents.
The introduction of anti-infectives was a significant step in the development of medicine, as it allowed to directly affect infection agents either by eliminating them (in case of bacteriocidic medications) or by hindering their reproduction (in case of bacteriostatic drugs) rather than counting on the patient’s immune system alone. The usage of anti-infectives has its adverse effects; when improperly used, they can exacerbate the condition of the patient, e.g., antibiotics can cause superinfection by eliminating a crucial part of the normal flora (Lilley, Rainforth Collins, & Snyder, 2014, p. 613).
Nowadays, however, there exist serious problems related to the usage of anti-infectives and the development of new drugs. The most crucial is the constant increase of antibiotics resistance in bacteria, which is due to antibiotics overuse not only for humans but also for farm animals; the latter perfectly allows for rapid development of drug-resistant microbes both in farm animals and in humans who consume their meat containing the remains of the medications (Mole, 2013). At the same time, the development of new antibiotics is extremely slow and does not allow to compensate for the emergence of antibiotic-resistant strains.
To prevent the development of the new strains of drug-resistant bacteria in patients, it is logical to treat infections caused by strains that easily develop resistance intensively, attempt to use mostly narrow-spectrum antibiotics where possible, and avoid prescribing antibiotics carelessly and unnecessarily.
Another problem is the development of new antivirals. Even though there currently exist more than 60 clinically effective antiviral drugs, many of them have disadvantages such as serious side effects or low bioavailability. However, antivirals have proven their utility, allowing for the treatment of serious diseases. For instance, the arrest of Herpesviridae multiplication was made possible, allowing for treatment of infections caused by Herpesviridae which can sometimes be lethal; HAART has been permitted to significantly increase the life expectancy and the quality of life of HIV-infected persons. However, there is a need for the development of new antivirals; for instance, the already mentioned HAART does not allow to cure the HIV infection completely, as well as the existing anti-herpes drugs (such as valaciclovir or ganciclovir) do not remove herpes’ DNA from the host’s cells and do not allow for complete recovery (Field & Wainberg, 2011; Lilley et al., 2014).
Adjunctive therapy is the treatment that amplifies or supplements the effect of the main therapy. Adjunctive therapy can be various; it can range from psychotherapy to the use of drugs such as chemotherapeutical medications (O’Donohue, & Cummings, 2011). It is often used in the treatment of cancer to reduce the chance of recurrence (Caley, Kanji, & Tanguay, 2012). Adjunctive therapy can also be used in addition to the main therapy with anti-infectives, or anti-infectives themselves may be used as adjuvant therapy.
An example of the latter is provided in a study where antibiotics were used on patients after acute-onset postcataract surgery to prevent the highly probable acute bacterial endophthalmitis and the visual loss (Hooper et al., 2012). Hooper et al. (2012) state that, according to some studies, the usage of antibiotics in such cases is controversial due to the absence of perceived difference in visual acuity; however, they stress that for the antibiotics used in the mentioned research (intravenous amikacin and ceftazidime) low intraocular penetration is characteristic. This is why Hooper et al. (2012) tested the usage of oral ciprofloxacin and moxifloxacin on such patients. The research showed that the patients who took moxifloxacin had a better vision after the clinical treatment, and, therefore, adjunctive moxifloxacin causes better clinical outcomes in the given situation (Hooper et al., 2012).
Therefore, it is possible to use adjunctive therapy in addition to the main therapy with anti-infectives, as well as it is possible to use anti-infectives themselves as adjunctive therapy.
References
Caley, A., Kanji, A., & Tanguay, J. (2012). Adjuvant therapy. Medicine 40(1), 1-4. Web.
Field, H. J., & Wainberg, M. A. (2011). Antiviral drug development. Future Virology, 6(5), 545-547. Web.
Hooper, C. Y., Lightman, S. L., Pacheco, P., Tam, P. M. K., Khan, A., & Taylor, S. R. J. (2012). Adjunctive antibiotics in the treatment of acute bacterial endophthalmitis following cataract surgery. Acta Ophthalmologica 90(7), e572-e573. Web.
Lilley, L. L., Rainforth Collins, S., & Snyder, J. S. (2014). Pharmacology and the nursing process (7th ed.). Amsterdam, Netherlands: Elsevier Health Sciences.
Mole, B. (2013). Farming up trouble. Nature, 499(7459), 398-400.
O’Donohue, W., & Cummings, N. A. (Eds.). (2011). Evidence-based adjunctive treatments. Burlington, MA: Elsevier.