6 Conclusion and Prospective Studies
Conventional therapies are insufficient to treat MRSA infection, and are even likely to weaken host immunity. TM therapies can regulate the host’s immune responses independently to combat MRSA infection. The combination of two therapies is a promising strategy and may display greater efficacy in bacterial infection treatment (Table. 2).
What conditions can combination therapy be used for? Generally, combination therapy can be used to prevent MRSA infection in specific populations. For HA-MRSA patients, especially permanent users of medical devices, removing contaminated devices may lead to the risk of bacterial infection. Combination therapy can reduce this risk. For the population with weakened immune systems, such as neonates and the elder. TM therapies can enhance their immunity. For patients with congenital and acquired diseases caused by impaired neutrophils number and function, combination therapy can increase the number and function of neutrophils[150]. Combination therapy can also prevent MRSA colonization. It can also be used for the treatment of MRSA infection. It can treat patients with low immunity who are infected by MRSA[68, 86, 145]. Additionally, combination therapy is a promising therapy for MRSA-BF infection[5, 6, 12].
Current findings have confirmed the synergistic effects of combination therapy [7, 8, 85]. However, most of these studies were performed in vitro and in animal models. Few clinical studies have been performed. Moreover, the corresponding mechanisms of combination therapy are not revealed. Real-world, multiple-center, international large-sample randomized controlled clinical trials should be conducted. In these trials, populations of different ethnicities are enrolled, and internationally unified efficacy evaluation standards and evaluation norms are adopted, which will aid the global recognition of this research. Network pharmacology techniques based on big data and multi-omics integration analysis approaches have marked advantages for revealing the mechanism of action of these herbs and formulae by integrating and analyzing the relationships among proteins, genes and metabolites. In summary, combination therapy is a promising immunotherapy strategy for MRSA infection, and the mechanisms need to be further elucidated.