{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T15:24:15Z","timestamp":1783092255710,"version":"3.54.6"},"reference-count":53,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T00:00:00Z","timestamp":1728345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T00:00:00Z","timestamp":1728345600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"MOST | National Natural Science Foundation of China","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2024,10,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              Limited treatment options and multidrug-resistant (MDR)\n              <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n              present a significant therapeutic challenge, underscoring the need for novel approaches. Drug repurposing is a promising tool for augmenting the activity of many antibiotics. This study aimed to identify novel synergistic drug combinations against\n              <jats:italic>K. pneumoniae<\/jats:italic>\n              based on drug repurposing. We used the clinically isolated GN 172867 MDR strain of\n              <jats:italic>K. pneumoniae<\/jats:italic>\n              to determine the reversal resistance activity of zidovudine (AZT). The combined effects of AZT and various antibiotics, including nitrofurantoin (NIT) and omadacycline (OMC), were examined using the checkerboard method, growth curves, and crystal violet assays to assess biofilms. An\n              <jats:italic>in vitro<\/jats:italic>\n              combination activity testing was carried out in 12 isolates of\n              <jats:italic>K. pneumoniae. In vivo<\/jats:italic>\n              murine urinary tract and lung infection models were used to evaluate the therapeutic effects of AZT + NIT and AZT + OMC, respectively. The fractional inhibitory concentration index and growth curve demonstrated that AZT synergized with NIT or OMC against\n              <jats:italic>K. pneumoniae<\/jats:italic>\n              strains. In addition, AZT + NIT inhibited biofilm formation and cleared mature biofilms.\n              <jats:italic>In vivo<\/jats:italic>\n              , compared with untreated GN 172867-infected mice, AZT + NIT and AZT + OMC treatment decreased colony counts in multiple tissues (\n              <jats:italic>P<\/jats:italic>\n              &lt; 0.05) and pathological scores in the bladder and kidneys (\n              <jats:italic>P<\/jats:italic>\n              &lt; 0.05) and increased the survival rate by 60% (\n              <jats:italic>P<\/jats:italic>\n              &lt; 0.05). This study evaluated the combination of AZT and antibiotics to treat drug-resistant\n              <jats:italic>K. pneumoniae<\/jats:italic>\n              infections and found novel drug combinations for the treatment of acute urinary tract infections. These findings suggest that AZT may exert significant anti-resistance activity.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/aac.00344-24","type":"journal-article","created":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T13:01:14Z","timestamp":1724850074000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":8,"title":["Zidovudine in synergistic combination with nitrofurantoin or omadacycline:\n            <i>in vitro<\/i>\n            and in murine urinary tract or lung infection evaluation against multidrug-resistant\n            <i>Klebsiella pneumoniae<\/i>"],"prefix":"10.1128","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5887-4266","authenticated-orcid":false,"given":"Ping","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases &amp; Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Anhui Province Key Laboratory of Infectious Diseases and Institute of Bacterial Resistance, Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing-Qing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases &amp; Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Anhui Province Key Laboratory of Infectious Diseases and Institute of Bacterial Resistance, Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Juan","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Hepatology, The First Affiliated Hospital of Jilin University, Changchun, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Zhu","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases &amp; Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Anhui Province Key Laboratory of Infectious Diseases and Institute of Bacterial Resistance, Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong-Qing","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases &amp; Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Anhui Province Key Laboratory of Infectious Diseases and Institute of Bacterial Resistance, Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya-Qin","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases &amp; Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Anhui Province Key Laboratory of Infectious Diseases and Institute of Bacterial Resistance, Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases &amp; Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Anhui Province Key Laboratory of Infectious Diseases and Institute of Bacterial Resistance, Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-Yan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases &amp; 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