Meropenem is a broad-spectrum carbapenem antibiotic essential for treating serious infections including urinary tract infections, pneumonia, sepsis, and meningitis. This narrative review examines meropenem resistance trends and prescribing practices for severe infections in Pakistan highlighting how inappropriate use drives local antimicrobial resistance. Relevant literature was identified through a structured search of PubMed, Scopus, Web of Science, and Google Scholar using predefined keywords. Antimicrobial resistance (AMR) is a global health crisis that complicates treatment of infections caused by multidrug-resistant Gram-negative pathogens, including Acinetobacter baumannii, Klebsiella pneumoniae, and E. coli. Pharmacokinetic studies of meropenem show extensive tissue penetration, time-dependent bactericidal activity, and rapid renal clearance, which contribute to its effectiveness. In critically ill patients, specialized dosing strategies like continuous or extended infusions are recommended to maintain adequate drug levels. Emerging evidence also supports combination therapies (e.g., pairing meropenem with fosfomycin) to improve outcomes against carbapenem-resistant strains. In Pakistan, these concerns are especially acute: many key pathogens show high resistance rates due to widespread antibiotic overuse and misuse. Regional surveillance indicates that E. coli often remains relatively sensitive to meropenem, whereas Acinetobacter species exhibit alarmingly low susceptibility. Such resistance largely stems from the spread of extended-spectrum beta-lactamases (ESBLs) and carbapenemase-producing organisms, posing serious challenges to clinicians. This underscores the need for data-driven, context-specific strategies to guide therapy. Robust surveillance systems are needed to guide empirical therapy, and real-time resistance monitoring can help prevent treatment failures. The review emphasizes targeted antimicrobial strategies and judicious meropenem use. Ongoing education for healthcare providers and coordinated stewardship programs at local and national levels are also essential to preserve the antibiotic's clinical utility. Ultimately, sustaining meropenem's effectiveness in the face of rising AMR requires combined public health efforts, including tailored dosing protocols and localized resistance management, to keep meropenem a reliable option worldwide for treating life-threatening infections.

Trypanosomatids, including the genera Trypanosoma and Leishmania, are protozoan parasites of significant medical and veterinary relevance. These organisms cause African trypanosomiasis, Chagas disease, and leishmaniasis, which are classified as neglected tropical diseases (NTDs). NTDs continue to present major public health challenges, particularly in sub-Saharan Africa, Latin America, and parts of Asia, resulting in substantial morbidity, mortality, and socioeconomic impacts. Chemotherapeutic interventions remain constrained by toxicity, high cost, limited accessibility, and the increasing prevalence of drug resistance. Significantly, there is a tight relationship between pathogenesis and drug resistance because processes that facilitate intracellular persistence, immunological evasion, and metabolic adaptation can also decrease drug sensitivity and increase treatment failure. This interaction makes it easier for more pathogenic and resilient strains to arise, which makes disease treatment and control more difficult. The absence of effective vaccines underscores the urgent need for novel therapeutic strategies. Advances in molecular parasitology have elucidated unique organellar structures, immune evasion mechanisms, and metabolic pathways in trypanosomatids, providing new therapeutic targets. Additionally, artificial intelligence and computational methodologies are facilitating drug discovery, predicting resistance, and improving diagnostics. In this review, we provide a narrative overview of current knowledge of trypanosomatid biology, prevalence, drug resistance mechanisms, and emerging control strategies. By integrating classical parasitology with computational approaches, new opportunities are identified to address resistance, enhance therapy, and mitigate the global health burden of trypanosomatid infections.

[This corrects the article DOI: 10.1155/ipid/5579320.].

Leprosy, caused by Mycobacterium lepromatosis or Mycobacterium leprae, has been reported in red squirrels in Britain from Scotland to the south of England. However, there has been no attempt to determine whether lesions caused by leprosy can be detected in the skeletons of infected animals. Here, we present findings from three red squirrel skeletons (Sciurus vulgaris L., 1758) that had soft tissue lesions consistent with leprosy and were positive for M. lepromatosis. Three of six red squirrel specimens from Scotland that previously tested positive for M. lepromatosis were subjected to macro- and microscopic skeletal analyses. Erosive lesions, remodelling and porosity were found in multiple parts of the skeleton, including the podials, tarsals, distal tibiae, distal forelimbs and in the nasal bones. Additionally, porous lesions were found in the caudal vertebrae. These skeletal changes advance our knowledge of how this disease manifests in nonhuman mammals. Overall, these findings demonstrate that, despite the squirrel's significantly shorter lifespan and different metabolism, comparable patterns of skeletal lesions are observed in humans and red squirrels with leprosy.