Therapeutic options and emerging alternatives for multidrug resistant staphylococcal infections

Maria Magana, Anastasios Ioannidis, Emmanouil Magiorkinis, Oleg Ursu, Cristian G. Bologa, Stylianos Chatzipanagiotou, Michael R. Hamblin, George P. Tegos

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


Methicillin-resistant Staphylococcus aureus (MRSA) remains the single biggest challenge in infectious disease in the civilized world. Moreover, vancomycin resistance is also spreading, leading to fears of untreatable infections as were common in ancient times. Molecular microbiology and bioinformatics have revealed many of the mechanisms involved in resistance development. Mobile genetic elements, up-regulated virulence factors and multi-drug efflux pumps have been implicated. A range of approved antibiotics from the glycopeptide, lipopeptide, pleuromutilin, macrolide, oxazolidinone, lincosamide, aminoglycoside, tetracycline, steptogramin, and cephalosporin classes has been employed to treat MRSA infections. The upcoming pipeline of drugs for MRSA includes some new compounds from the above classes, together with fluoroquinolones, antibacterial peptide mimetics, aminomethylciclines, porphyrins, peptide deformylase inhibitors, oxadiazoles, and diaminopyrimidines. A range of non-drug alternative approaches has emerged for MRSA treatment. Bacteriophage-therapy including purified lysins has made a comeback after being discovered in the 1930s. Quorum-sensing inhibitors are under investigation. Small molecule inhibitors of multi-drug efflux pumps may potentiate existing antibiotics. The relative failure of staphylococcal vaccines is being revisited by efforts with multi-valent vaccines and improved adjuvants. Photodynamic therapy uses non-toxic photosensitizers and harmless visible light to produce reactive oxygen species that can nonspecifically destroy bacteria while preserving host cells. Preparation of nanoparticles can kill bacteria themselves, as well as improve the delivery of anti-bacterial drugs. Anti-MRSA drug discovery remains an exciting field with great promise for the future.

Original languageEnglish
Pages (from-to)2058-2072
Number of pages15
JournalCurrent Pharmaceutical Design
Issue number16
Publication statusPublished - 1 May 2015
Externally publishedYes


  • Drug discovery
  • MRSA
  • Multidrug resistance
  • Staphylococcal infections

ASJC Scopus subject areas

  • Pharmacology
  • Drug Discovery


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