If we find synergism between two antibacterial drugs (phytochemical allicin + commercial antibiotics) in vitro then will it work in in vivo situation? What interfering factors might cause problems? What can be done to mitigate those challanges? Please provide some suitable literatures also.
One difficulty is matching the pharmacokinetics and dosing regimens of the two drugs so that they are present in the patient simultaneously at sufficient concentrations.
Another issue is that the degree of synergy may not be the same for every strain of a given bacterial pathogen species.
Dear Souptik Bhattacharya ,
Synergy is often achieved in clinical practice, especially in the case of multi-drug resistant strains with a high power of selection of resistant mutants. It allows the reduction of the dose of each one and thus improves tolerance.
In vivo synergy depends on the pharmacokinetics of each of the two antibiotics, their diffusion in the site of infection, their concentrations at this site and it also depends on the strain.
Here are a few papers that I hope you will find useful:
1. doi:10.3390/antibiotics9040185
2. https://www.microbiologyresearch.org/docserver/fulltext/jmm/67/1/139_jmm000649.pdf?expires=1614931582&id=id&accname=guest&checksum=B72B9824248F470F92274116927F9B05
3. Article In vitro and in vivo bactericidal activity of ceftazidime-av...
4. Article In vitro and in vivo assessment of the antibacterial activit...
5. https://academic.oup.com/jac/advance-article/doi/10.1093/jac/dkaa543/6094930
6. https://www.frontiersin.org/articles/10.3389/fmicb.2019.02430/full
7. Article In vitro and in vivo activity of ciprofloxacin/fosfomycin co...
8. https://www.karger.com/Article/Abstract/220868
9. https://core.ac.uk/download/pdf/85220405.pdf
Good luck
Synergy in vivo depends on the pharmacokinetics of each antibiotic, and their efficacy at the site of infection,
It also depends on the presence of a similarity link between the type of strain and the type of antibiotic used
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