Cationic antimicrobial peptides as potential new therapeutic agents in neonates and children: a review.
OBJECTIVE
Antimicrobial resistance towards conventional antibiotics is a serious problem for modern medicine and for our society. Multidrug-resistant bacteria are very difficult to treat and treatment options have begun to run out. Here, we summarize the newest studies of drug development using cationic antimicrobial peptides as lead molecules for novel antimicrobial drugs.


RESULTS
A new development is the use of antimicrobial peptides not only as direct antimicrobial lead structures but also using their ability to influence the immune system. Such approaches can be used to develop drugs that influence the immune system in a unique way, supporting specific branches of immune cells in order to clear infection. Applying such an 'immune boost' would also minimize the danger of new resistance emerging in bacteria. In addition, searching for and testing substances that trigger the production of host antimicrobial peptides is still ongoing and opens up a totally new avenue for the use of antimicrobial peptides against infections. Currently, more than 10 clinical trials, phase 2 or 3, using antimicrobial peptides are in progress or have been recently completed.


CONCLUSIONS
Multidrug resistance is an urgent problem for modern medicine and novel antimicrobials are needed. Despite some drawbacks, antimicrobial peptides seem now to appear more numerous in clinical trials, indicating the success in developing peptides into novel therapeutics. This can be critical especially for neonates and children, as treatment options for infections with Gram-negatives in neonatal ICUs are becoming rare.
Infection and Immunity Research Institute, St. George's University of London, London, UK *Martin Ashby and Asya Petkova contributed equally.
Martin
M
Ashby
Asya
A
Petkova
Kai
K
Hilpert
D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D023181:Antimicrobial Cationic Peptides / Q000494:pharmacology* / Q000627:therapeutic use; D001798:Blood Proteins / Q000494:pharmacology* / Q000627:therapeutic use; D002352:Carrier Proteins / Q000494:pharmacology* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000188:drug therapy* / Q000276:immunology; D015195:Drug Design; D006801:Humans; D007167:Immunotherapy; D007223:Infant; D007231:Infant, Newborn
C062991:AZU1 protein, human; D000900:Anti-Bacterial Agents; D023181:Antimicrobial Cationic Peptides; D001798:Blood Proteins; D002352:Carrier Proteins