Cyclodextrin inclusion complexes improving antibacterial drug profiles: an update systematic review
Abstract
Aim: The study aimed to review experimental models using cyclodextrins to improve antibacterial drugs' physicochemical characteristics and biological activities. Methods: The following terms and their combinations were used: cyclodextrins and antibacterial agents in title or abstract, and the total study search was conducted over a period up to October 2022. The review was carried out using PubMed, Scopus and Embase databases. A total of 1580 studies were identified, of which 27 articles were selected for discussion in this review. Results: The biological results revealed that the antibacterial effect of the inclusion complexes was extensively improved. Cyclodextrins can enhance the therapeutic effects of antibiotics already existing on the market, natural products and synthetic molecules. Conclusion: Overall, CDs as drug-delivery vehicles have been shown to improve antibiotics solubility, stability, and bioavailability, leading to enhanced antibacterial activity.
Plain language summary
The overuse of drugs can cause bacteria to become less susceptible to them. This is known as resistance. One idea on how to tackle this resistance is by using cyclodextrins (CDs). CDs can change how drugs work, making them better at fighting bacteria. As CDs are already used in making drugs, they are a good choice for the basis of creating new drugs.
Tweetable abstract
Cyclodextrins play a crucial role in enhancing the physical and chemical characteristics of drugs, leading to improved bioavailability, biodistribution and solubility.
Graphical abstract
Cyclodextrin inclusion complexes and their use as new antibacterial therapeutic alternatives.
Papers of special note have been highlighted as: •• of considerable interest
References
- 1. Epidemiology of antimicrobial resistance in Lebanese extra-hospital settings: an overview. J. Glob. Antimicrob. Resist. 17, 123–129 (2019).
- 2. . The resistance tsunami, antimicrobial stewardship, and the golden age of microbiology. Vet. Microbiol. 171(3–4), 273–278 (2014).
- 3. . Differential drivers of antimicrobial resistance across the world. Acc. Chem. Res. 52(4), 916–924 (2019).
- 4. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet 399(10325), 629–655 (2022).
- 5. . Antibiotic consumption trends in China: evidence from six-year surveillance sales records in Shandong Province. Front. Pharmacol. 11, 1 (2020).
- 6. . Review of antibiotic resistance in China and its environment. Environ. Int. 110, 160–172 (2018).
- 7. . Editorial: the global threat of carbapenem-resistant Gram-negative bacteria, volume II. Front. Cell. Infect. Microbiol. 13, 1–3 (2023).
- 8. Center of Disease Control Antibiotic Resistance Threats Report. CDC, GA, USA (2019). https://www.cdc.gov/drugresistance/biggest-threats.html
- 9. . Nanotechnology as a therapeutic tool to combat microbial resistance. Adv. Drug Deliv. Rev. 65(13–14), 1803–1815 (2013).
- 10. . Development of chitosan films containing β-cyclodextrin inclusion complex for controlled release of bioactives. Food Hydrocoll. 104,
doi: 10.1016/j.foodhyd.2020.105720 (2020) (Epub ahead of print). - 11. . Solubility of cyclodextrins and drug/cyclodextrin complexes. Molecules 23(5), 1–15 (2018).
- 12. . Cyclodextrin-based delivery systems for cancer treatment. Mater. Sci. Eng. C 96, 872–886 (2019).
- 13. . Cyclodextrins: potential therapeutics against atherosclerosis. Pharmacol. Ther. 214,
doi: 10.1016/j.pharmthera.2020.107620 (2020) (Epub ahead of print). - 14. Methyl-β-cyclodextrin suppresses the monocyte-endothelial adhesion triggered by lipopolysaccharide (LPS) or oxidized low-density lipoprotein (oxLDL). Pharm. Biol. 59(1), 1034 (2021).
- 15. . Cyclodextrin inclusion complexes with antibiotics and antibacterial agents as drug-delivery systems – a pharmaceutical perspective. Pharmaceutics 14(7), 1–71 (2022).
- 16. Physico-chemical characterization and antibacterial activity of inclusion complexes of Hyptis martiusii Benth essential oil in β-cyclodextrin. Biomed. Pharmacother. 89, 201–207 (2017).
- 17. Advances of nanosystems containing cyclodextrins and their applications in pharmaceuticals. Int. J. Pharm. 559, 312–328 (2019).
- 18. . The use of cyclodextrin inclusion complexes to improve anticancer drug profiles: a systematic review. Expert Opin. Drug Deliv. 17(8), 1069–1080 (2020).
- 19. . Cyclodextrins: improving the therapeutic response of analgesic drugs: a patent review. Expert Opin. Ther. Pat. 25(8), 897–907 (2015).
- 20. . Inclusion complex with cyclodextrins enhances the bioavailability of flavonoid compounds: a systematic review. Phytochem. Rev. 18(5), 1337–1359 (2019). •• Antibiotics and cyclodextrin inclusion complexes.
- 21. . Preparation & characterization of solid inclusion complex of cefpodoxime proxetil with β-cyclodextrin. Curr. Drug Deliv. 5(1), 1–6 (2008).
- 22. . Effect of β-cyclodextrin and hydroxypropyl β-cyclodextrin complexation on physicochemical properties and antimicrobial activity of cefdinir. J. Pharm. Biomed. Anal. 47(3), 535–540 (2008).
- 23. Computer-aided design of cefuroxime axetil/cyclodextrin system with enhanced solubility and antimicrobial activity. Biomolecules 10(1), 24 (2019).
- 24. Investigation of β-cyclodextrin-norfloxacin inclusion complexes. Part 1. Preparation, physicochemical and microbiological characterization. Expert Rev. Anti. Infect. Ther. 13(1), 119–129 (2015).
- 25. Multifunctionality of βcD/ofloxacin and HPβCD/ofloxacin complexes: improvement of the antimicrobial activity and apoptosis induction on lung adenocarcinoma A549 cells. J. Braz. Chem. Soc. 31(12), 2628–2637 (2020).
- 26. . Enhanced antibacterial activity of levofloxacin/hydroxypropyl-β-cyclodextrin inclusion complex: in vitro and in vivo evaluation. Colloids Surf. B Biointerfaces 215,
doi: 10.1016/j.colsurfb.2022.112514 (2022) (Epub ahead of print). - 27. Tedizolid-cyclodextrin system as delayed-release drug delivery with antibacterial activity. Int. J. Mol. Sci. 22(1), 1–15 (2020).
- 28. Structural and thermodynamic characterization of doxycycline/β-cyclodextrin supramolecular complex and its bacterial membrane interactions. Colloids Surf. B Biointerfaces 118, 194–201 (2014).
- 29. Antimicrobial activity of fusidic acid inclusion complexes. Int. J. Infect. Dis. 101, 65–73 (2020).
- 30. Cyclodextrins as multifunctional excipients: influence of inclusion into β-cyclodextrin on physicochemical and biological properties of tebipenem pivoxil. PLOS ONE 14(1), e0210694 (2019).
- 31. Theoretical and experimental study of inclusion complexes formed by isoniazid and modified β-cyclodextrins: 1 H NMR structural determination and antibacterial activity evaluation. J. Phys. Chem. B 118(1), 81–93 (2014).
- 32. . Improvement on dissolution rate of inclusion complex of rifabutin drug with β-cyclodextrin. Int. J. Biol. Macromol. 62, 472–480 (2013).
- 33. Characterization, activity, and computer modeling of a molecular inclusion complex containing rifaldazine. Int. J. Nanomedicine 8, 477–484 (2013).
- 34. . Improved activity of rifampicin against biofilms of Staphylococcus aureus by multicomponent complexation. AAPS PharmSciTech 21(5), 163 (2020). •• Natural products and cyclodextrin inclusion complexes.
- 35. . Effect of selective encapsulation of hydroxypropyl-β-cyclodextrin on components and antibacterial properties of star anise essential oil. Molecules 23(5), 1126 (2018).
- 36. Characterization, solubility and antibacterial activity of inclusion complex of questin with hydroxypropyl-β-cyclodextrin. 3 Biotech 9(4), 123 (2019).
- 37. Parietin cyclodextrin-inclusion complex as an effective formulation for bacterial photoinactivation. Pharmaceutics 14(2), 357 (2022).
- 38. . Ultrasound processed cuminaldehyde/2-hydroxypropyl-β-cyclodextrin inclusion complex: preparation, characterization and antibacterial activity. Ultrason. Sonochem. 56, 84–93 (2019).
- 39. Preparation, characterization and antimicrobial activity of inclusion complex of biochanin A with (2-hydroxypropyl)-β-cyclodextrin. J. Pharm. Pharmacol. 70(11), 1485–1493 (2018).
- 40. Evaluation of the antibacterial and modulatory potential of α-bisabolol, β-cyclodextrin and α-bisabolol/β-cyclodextrin complex. Biomed. Pharmacother. 92, 1111–1118 (2017).
- 41. . Antibacterial mechanism of artemisinin/beta-cyclodextrins against methicillin-resistant Staphylococcus aureus (MRSA). Microb. Pathog. 118, 66–73 (2018).
- 42. Inhalable andrographolide-β-cyclodextrin inclusion complexes for treatment of Staphylococcus aureus pneumonia by regulating immune responses. Mol. Pharm. 14(5), 1718–1725 (2017).
- 43. . Pulmonary delivery of tea tree oil-β-cyclodextrin inclusion complexes for the treatment of fungal and bacterial pneumonia. J. Pharm. Pharmacol. 69(11), 1458–1467 (2017).
- 44. . Encapsulation of essential oil components with methyl-β-cyclodextrin using ultrasonication: solubility, characterization, DPPH and antibacterial assay. Ultrason. Sonochem. 64,
doi: 10.1016/j.ultsonch.2020.104997 (2020) (Epub ahead of print). - 45. Development and evaluation of antimicrobial and modulatory activity of inclusion complex of Euterpe oleracea Mart oil and β-cyclodextrin or HP-β-cyclodextrin. Int. J. Mol. Sci. 21(3), 942 (2020). •• Synthetic molecules and cyclodextrin inclusion complexes.
- 46. . Partial inclusion of bis(1,10-phenanthroline) silver(I) salicylate in β-cyclodextrin: spectroscopic characterization, in vitro and in silico antimicrobial evaluation. An. Acad. Bras. Cienc. 92(3), e20181323 (2020).
- 47. Antimicrobial peptide temporin-L complexed with anionic cyclodextrins results in a potent and safe agent against sessile bacteria. Int. J. Pharm. 584, 1–37 (2020).
- 48. . Cyclodextrins and their uses: a review. Process Biochem. 39(9), 1033–1046 (2004).
- 49. . Cyclodextrins: more than pharmaceutical excipients. Mini-Rev. Med. Chem. 10(8), 715–725 (2010).
- 50. . Cyclodextrins: structure, physicochemical properties and pharmaceutical applications. Int. J. Pharm. 535(1–2), 272–284 (2018).
- 51. . Cyclodextrin-based delivery systems for chemotherapeutic anticancer drugs: a review. Carbohydr. Polym. 232,
doi: 0.1016/j.carbpol.2019.115805 (2020) (Epub ahead of print). - 52. Cyclodextrin-based delivery systems for in vivo-tested anticancer therapies. Drug Deliv. Transl. Res. 11(1), 49–71 (2021).
- 53. Cyclodextrin-drug inclusion complexes: in vivo and in vitro approaches. Int. J. Mol. Sci. 20(3), 1–27 (2019).
- 54. . Cyclodextrins as pharmaceutical solubilizers. Adv. Drug Deliv. Rev. 59(7), 645–666 (2007).
- 55. . Introduction and general overview of cyclodextrin chemistry. Chem. Rev. 98(5), 1743–1753 (1998).
- 56. . Cyclodextrin-based delivery systems for cancer treatment. Mater. Sci. Eng. C 96, 872–886 (2019).
- 57. . Cyclodextrin-based pharmaceutics: past, present and future. Nat. Rev. Drug Discov. 3(12), 1023–1035 (2004).
- 58. . Formulation. In: Drug-Like Properties. Elsevier, CA, USA, 497–510 (2016).
- 59. The influence of hydroxypropyl-β-cyclodextrin on the solubility, dissolution, cytotoxicity, and binding of riluzole with human serum albumin. J. Pharm. Biomed. Anal. 117, 453–463 (2016).
- 60. . Cyclodextrins: assessing the impact of cavity size, occupancy, and substitutions on cytotoxicity and cholesterol homeostasis. Molecules 23(5), 1228 (2018).
- 61. . Cyclodextrins inclusion complex: preparation methods, analytical techniques and food industry applications. Food Chem. 384, 1–14 (2022).
- 62. . Chapter 15 – Alternative technologies to improve solubility and stability of poorly water-soluble drugs. In: Multifunctional Systems for Combined Delivery, Biosensing and Diagnostics. Grumezescu AM (Ed.). Elsevier, 281–305 (2017).
- 63. . Analytical techniques for characterization of cyclodextrin complexes in the solid state: a review. J. Pharm. Biomed. Anal. 113, 226–238 (2015).
- 64. . Analytical characterization of cyclodextrins: history, official methods and recommended new techniques. J. Pharm. Biomed. Anal. 130, 347–365 (2016).
- 65. . Cyclodextrins in delivery systems: applications. J. Pharm. Bioallied Sci. 2(2), 72 (2010).
- 66. . Membrane cholesterol: a crucial molecule affecting interactions of microbial pathogens with mammalian cells. Infect. Immun. 73(12), 7791 (2005).
- 67. . Pathogenicity and virulence of Staphylococcus aureus. Virulence 12(1), 547–569 (2021).
- 68. Methicillin-resistant Staphylococcus aureus: an overview of basic and clinical research. Nat. Rev. Microbiol. 17(4), 203–218 (2019).
- 69. . Secreted virulence factor comparison between methicillin-resistant and methicillin-sensitive Staphylococcus aureus, and its relevance to atopic dermatitis. J. Allergy. Clinical Immunology. 125(1), 39–49 (2010).
- 70. . Untargeted lipidomic differences between clinical strains of methicillin-sensitive and methicillin-resistant Staphylococcus aureus. Infect. Dis. (Lond.) 54(7), 497–507 (2022).
- 71. . Methicillin-resistant Staphylococcus aureus has greater risk of transmission in the operating room than methicillin-sensitive S aureus. Am. J. Infect. Control 46(5), 520–525 (2018).
- 72. . WHO global priority pathogens list: a bibliometric analysis of Medline-PubMed for knowledge mobilization to infection prevention and control practices in Bahrain. Oman Med. J. 34(3), 184–193 (2019).
- 73. . Cyclodextrin derivatives as anti-infectives. Curr. Opin. Pharmacol. 13(5), 717–725 (2013).
- 74. Mapping of new pharmacological alternatives in the face of the emergence of antibiotic resistance in COVID-19 patents treated for opportunistic respiratory bacterial pathogens. Recent Adv. Antiinfect. Drug Discov. 17(1), 34–53 (2022).
- 75. . Evaluation of medicine prescription pattern using World Health Organization prescribing indicators in Iran: a cross-sectional study. J. Res. Pharm. Pract. 3(2), 39 (2014).
- 76. . Cyclodextrin complexes for treatment improvement in infectious diseases. Nanomedicine 10(10), 1621–1641 (2015).
- 77. . Effects of cyclodextrins on the chemical stability of drugs. Int. J. Pharm. 531(2), 532–542 (2017).
- 78. . Pharmacokinetic and pharmacodynamic principles of anti-infective dosing. Clin. Ther. 38(9), 1930–1947 (2016).
- 79. . A comparative study of artificial membrane permeability assay for high throughput profiling of drug absorption potential. Eur. J. Med. Chem. 37(5), 399–407 (2002).
- 80. . Solubility behavior and biopharmaceutical classification of novel high-solubility ciprofloxacin and norfloxacin pharmaceutical derivatives. Int. J. Pharm. 371(1–2), 106–113 (2009).
- 81. . The effect of temperature and pH on the solubility of quinolone compounds: estimation of heat of fusion. Pharm. Res. 11(4), 522–527 (1994).
- 82. . Cyclodextrins: a weapon in the fight against antimicrobial resistance. J. Mol. Eng. Mater. 5(1), (2017) (Epub ahead of print).
- 83. . Effect of selective encapsulation of hydroxypropyl-β-cyclodextrin on components and antibacterial properties of star anise essential oil. Molecules 23(5), 1–15 (2018).
- 84. Inclusion complex of barbigerone with hydroxypropyl-β-cyclodextrin: preparation and in vitro evaluation. Carbohydr. Polym. 101(1), 623–630 (2014).
- 85. . Antibiotics and bacterial resistance in the 21st century. Perspect. Medicin. Chem. 6(6), 25 (2014).