The treatment of melioidosis: is there a role for repurposed drugs? A proposal and review

Figures & data

Table 1. In-use pharmaceuticals found to have some direct antimicrobial effects in studies [55,56].

Drug	Class	Clinical Use
Alendronate Clodronate	Bisphosphonate	Inhibit recruitment and promote apoptosis of osteoclasts reducing resorption and turnover of boneUsed in:Paget’s DiseaseHypercalcaemia secondary to malignancy Prevention/therapy of post-menopausal osteoporosis Prevention/therapy of glucocorticoid-induced osteoporosis Therapy of cancer metastases in bone
Aciclovir	DNA Polymerase Inhibitor	Antiviral for Herpes viridae Used in: Prophylaxis/therapy of Herpes simplex 1 and 2 and Varicella zoster infection
Alverine		Antispasmodic Used in: Gastro-intestinal disorders characterized by smooth muscle spasm Dysmenorrhea
Butorphanol Tramadol	μ-opioid receptor partial agonist and antagonist	Opioid analgesia
Diclofenac Etodolac Naproxen Oxaprozin Tolfenamic acid	Non-steroidal anti-inflammatory (NSAID)	COX-1/COX-2 inhibitors Anti-inflammatory, analgesia, antipyrexial
Emastadine Levocabastine	H1 receptor antagonist	Topical antihistamine for allergic conjunctivitis
Fluvastatin	Statin	HMG-CoA reductase inhibitor Reduction of cholesterol
Ketamine	Anesthetic	Anesthetic
Losartan Telmisartan	Angiotensin II receptor antagonist	Anti-hypertensive Also used in cardiac failure
Matipranolol	Non-selective beta blocker	Topical for glaucoma
Mesalazine	Aminosalicylate	Ulcerative colitis
Oxymethazoline	α1 adrenergic receptor agonist and α2 adrenergic receptor partial agonist	Nasal decongestant
Proxymetacaine	Antagonist on voltage-gated sodium channels	Topical ophthalmic local anesthetic
Ribavarin	Adenosine/Guanosine analog	AntiviralUsed in:Respiratory Syncytial Virus Hepatitis C Arenavirus infection (e.g. Lassa Fever) Bunyavirus infection (e.g. Congo-Crimean Hemorrhagic Fever)
Rutin	Dietary Supplement	Vascular protection
Sulodexide	Anticoagulant	Prophylaxis/therapy of vascular thrombo-embolic disease
Tegaserod	5-HT4 agonist	Gut motility agent
Temozolomide	Alkylating agent	Chemotherapy for brain tumors
Ticlopidine	Adenosine diphosphate (ADP) receptor inhibitor	Prophylaxis/therapy of vascular thrombo-embolic disease
Tropicamide	Anticholinergic	Short acting mydriatic
Ebselen	Organoselenium compound mimicking glutathione peroxidase	Potential as a therapy for reperfusion injury, stroke, hearing loss and tinnitus, and bipolar disorder Activity against Clostridium difficile
5-fluoro-2ʹ-deoxyuridine Raltitrexed	Thymidylate Synthase inhibitor	Chemotherapy for colorectal tumors
Epirubicin Daunorubicin Idarubicin	Anthracycline	Chemotherapy for a variety of malignancies
Toremifene^1 Tamoxifen^2 Clomifene^3	Selective estrogen receptor modulator	Chemotherapy for some prostate malignanciesPrevention/therapy of breast malignancies Infertility treatment
Isoprenaline	Non-selective β adreno-receptor agonist	Treatment for bradycardia and heart block
Oxiconazole Bifonazole Clotrimazole Econazole Miconazole	Azole	Antifungal
Triclabendazole	Benzimidazole	Antihelminthic
Carmofur 5-Fluorouracil Ftorafur	Pyrimidine analog	Chemotherapy for a variety of malignancies
MK-886	Leukotriene antagonist	5-lipoxygenase-activating protein inhibitor and COX-1 inhibitor Anti-inflammatory
5-Nonloxytryptamine	Serotonin receptor agonist	Variety of different types of agonist used as antidepressants or migraine therapy
Dactinomycin	Actinomycine	Chemotherapy for a variety of malignancies
Acetazolamide	Carbonic anhydrase inhibitor	Used in:GlaucomaEpilepsyPeriodic paralysisCentral sleep apnoeaIdiopathic intracranial hypertensionAltitude sicknessDural ectasiaCystinuria
Furosemide	Loop diuretic	Used in:Peripheral edema due to cardiac or hepatic failurePulmonary edemaCerebral edemaHypertension

Table 2. Inhibition of IL-1β can be achieved by a number of drugs.

Drug	Class	Clinical Use
Anakinra	Recombinant interleukin 1 receptor antagonist	Rheumatoid Arthritis
Canakinumab	Monoclonal Antibody	Cryopyrin-associated periodic syndromes (CAPS). Gout
Chloroquine	4-aminoquinoline	Antimalarial
Rilonacept	Dimeric fusion protein consisting of IL-1 receptor component and IL-1 receptor accessory protein	Cryopyrin-associated periodic syndromes (CAPS)
Sitagliptin	Dipeptidyl peptidase-4 (DPP-4) inhibitor	Diabetes

Kruszewska H, Zareba T, Tyski S. Search of antimicrobial activity of selected non-antibiotic drugs. Acta Pol Pharm. 2002 Nov-Dec;59(6):436–439.

 PubMedGoogle Scholar

Younis W, Thangamani S, Seleem MN. Repurposing non-antimicrobial drugs and clinical molecules to treat bacterial infections. Curr Pharm Des. 2015;21(28):4106–4111.

 PubMed Web of Science ®Google Scholar