Probiotics and antibiotics

By 1945, with penicillin heralding the dawn of antibiotic therapy, Sir Alexander Fleming had warned ‘that the high public demand of antibiotics would determine an “era of abuse”; this eventually became a reality’ (Lobanovska and Pilla, 2017). Further confirmation came this year when the European Centre for Disease Prevention and Control (ECDC) reported that data for 2021 from the World Health Organization's European Region showed that ‘33% of the countries reported resistance percentages of 25% or higher in K. pneumoniae. Carbapenem resistance was also common in Pseudomonas aeruginosa and Acinetobacter species, and at a higher percentage than in K. pneumoniae’ (ECDC, 2023).

To mitigate such challenges while promoting antibiotic stewardship, alternative antibiotic-free approaches to bacterial infections are being explored. For example, Costa-Pinta et al (2021), in addressing prosthetic joint infection involving implanted prostheses – often necessitating prosthetic removal and antibiotic administration – consider the introduction of natural antimicrobial compounds like chitosan into prostheses: ‘Chitosan is a potential valuable biomaterial presenting properties such as biocompatibility, biodegradability, low immunogenicity, wound healing ability, antimicrobial activity, and anti-inflammatory potential.’