多重耐药病原体的持续出现引发了寻求替代治疗方案的兴趣。抗菌组合疗法就是这样一种途径。已经进行了许多研究，涉及细菌素与其他抗微生物剂的组合，以规避抗微生物剂耐药性的发展和/或增加抗微生物效力。这种细菌素 - 抗微生物组合可以具有巨大的价值，就降低由于涉及两种不同的抗微生物作用机制而引起的抗性发展的可能性而言。此外，通过降低昂贵的抗微生物剂的浓度并将其与便宜的抗微生物剂组合使用，抗微生物协同相互作用也可能具有潜在的财务影响。此外，与细菌素组合治疗可以扩大抗微生物谱并且/或导致有效治疗所需的抗生素浓度降低至可以减少或消除潜在毒性或不良副作用的程度。在这里，我们回顾研究发现细菌素与其他抗菌剂联合使用是有效的，目的是针对临床和/或食源性病原体。此外，我们讨论了目前阻碍细菌素发展成为可行治疗选择的一些瓶颈，并解决了在试图预测细菌素 - 抗微生物组合的临床结果时需要谨慎的问题。

The continuing emergence of multi-drug resistant pathogens has sparked an interest in seeking alternative therapeutic options. Antimicrobial combinatorial therapy is one such avenue. A number of studies have been conducted, involving combinations of bacteriocins with other antimicrobials, to circumvent the development of antimicrobial resistance and/or increase antimicrobial potency. Such bacteriocin-antimicrobial combinations could have tremendous value, in terms of reducing the likelihood of resistance development due to the involvement of two distinct mechanisms of antimicrobial action. Furthermore, antimicrobial synergistic interactions may also have potential financial implications in terms of decreasing the costs of treatment by reducing the concentration of an expensive antimicrobial and utilizing it in combination with an inexpensive one. In addition, combinatorial therapies with bacteriocins can broaden antimicrobial spectra and/or result in a reduction in the concentration of an antibiotic required for effective treatments to the extent that potentially toxic or adverse side effects can be reduced or eliminated. Here, we review studies in which bacteriocins were found to be effective in combination with other antimicrobials, with a view to targeting clinical and/or food-borne pathogens. Furthermore, we discuss some of the bottlenecks which are currently hindering the development of bacteriocins as viable therapeutic options, as well as addressing the need to exercise caution when attempting to predict clinical outcomes of bacteriocin-antimicrobial combinations.

https://www.frontiersin.org/articles/10.3389/fmicb.2017.01205/full