Peptides as a therapeutic strategy against Klebsiella pneumoniae.

Increasing levels of resistance to conventional antibiotics have led to a search for new therapeutic options against bacterial infections. Klebsiella pneumoniae is considered a world health problem due to high levels of mortality associated with resistance to multiple antibiotics. Antimicrobial peptides (AMPs) have showed activity against this bacterium, which makes them a promising alternative in tackling resistance. In this article, we carried out an overview of the recent development of AMPs against K. pneumoniae using different designs and acting by different mechanisms, such as a recently proposed one against capsulated strains. Moreover, we outline AMPs' therapeutic potential when tested in combination with conventional antibiotics and against biofilms. Furthermore, challenges and perspectives for applying AMPs in clinical practice are discussed here.

Medical-surgical management and clinical outcome in cervical abscesses.

INTRODUCTION: This study aims at defining through a retrospective evaluation, the clinical parameters affecting the clinical course and consequently the management of patients presenting with cervicofacial abscesses. METHODOLOGY: A total of 394 patients diagnosed with abscess at the University of Sassari Otorhinolaryngology Division between 2009 and 2017 were included; among these, eleven patients were diagnosed with necrotizing fasciitis. Personal and clinical parameters including the LRINEC score and the medical and/or surgical treatment used were analyzed for each patient. The most frequently affected site was the peritonsillar space (76.9%), followed by the parapharyngeal space. RESULTS: Mean age was 41(±17) years, the male population was slightly overrepresented (68%). An average of 6 (±7) days of hospitalization duration was recorded. The mortality rate was confirmed to be relatively low (1/349 patients) and was reported only in one patient diagnosed with necrotizing fasciitis (1/11). CONCLUSION: Diagnosis, correct clinical definition and early medical-surgical treatment of neck abscesses were crucial to reduce complications; LRNEC score, C-reactive protein, glycemia and creatininemia proved to be reliable prognostic indicators of difficult patient management and risk of complications.