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Cationic antimicrobial peptides as potential new therapeutic agents in neonates and children: a review

Ashby, Martin*; Petkova, Asya*; Hilpert, Kai

Current Opinion in Infectious Diseases: June 2014 - Volume 27 - Issue 3 - p 258–267
doi: 10.1097/QCO.0000000000000057

Purpose of review 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.

Recent findings 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.

Summary 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.

Correspondence to Kai Hilpert, St. Georges University of London, Infection and Immunity Research Institute, Cranmer Terrace, London SW17 0RE, UK. Tel: +44 (0)208 266 6723; fax: +44 (0)208 725 3487; e-mail:

© 2014 Lippincott Williams & Wilkins, Inc.