Background Despite the various strategies undertaken in the clinical practice, the mortality rate due to antibiotic-resistant microbes has been markedly increasing worldwide. In addition to multidrug-resistant (MDR) microbes, the “ESKAPE” bacteria are also emerging. Of course, the infection caused by ESKAPE cannot be treated even with lethal doses of antibiotics. Now, the drug resistance is also more prevalent in antiviral, anticancer, antimalarial and antifungal chemotherapies. Main body To date, in the literature, the quantum of research reported on the discovery strategies for new antibiotics is remarkable but the milestone is still far away. Considering the need of the updated strategies and drug discovery approaches in the area of drug resistance among researchers, in this communication, we consolidated the insights pertaining to new drug development against drug-resistant microbes. It includes drug discovery void, gene paradox, transposon mutagenesis, vitamin biosynthesis inhibition, use of non-conventional media, host model, target through quorum sensing, genomic-chemical network, synthetic viability to targets, chemical versus biological space, combinational approach, photosensitization, antimicrobial peptides and transcriptome profiling. Furthermore, we optimally briefed about antievolution drugs, nanotheranostics and antimicrobial adjuvants and then followed by twelve selected new feasible drug targets for new drug design against drug resistance. Finally, we have also tabulated the chemical structures of potent molecules against antimicrobial resistance. Conclusion It is highly recommended to execute the anti-drug resistance research as integrated approach where both molecular and genetic research needs to be as integrative objective of drug discovery. This is time to accelerate new drug discovery research with advanced genetic approaches instead of conventional blind screening.

Post-Partum Hemorrhage (PPH) is defined as the loss of blood which is greater than 500ml after vaginal delivery or greater than 1000 ml after a cesarean section delivery. About 28% of the total maternal deaths were due to PPH particularly in developing countries. Oxytocin has been considered as the ‘gold standard’ drug in the treatment and prevention of PPH. Prophylactic use of prostaglandin analogue i.e., misoprostol in addition to oxytocin during cesarean section is expected to reduce the incidence of PPH. This study aims at comparing the efficacy of combined use of rectal misoprostol and oxytocin infusion with oxytocin in the prevention of PPH. A comparative observational study was conducted on 200 subjects which were divided into two equal groups by Simple Random Selection. One group was treated with Inj. Oxytocin 20U I.V infusion alone while the other group was treated with Tab. Misoprostol 600mcg, rectal route and Inj. Oxytocin 20U I.V infusion. Majority of the subjects were observed under the age group of 21-25years, under primigravidae. A significant decrease in the volume of mean blood loss (740.00 ± 164.00 ml: p = 0.045) and the mean drop of hemoglobin level(Hb) (0.88±0.74gm/dl; p = 0.0001) were observed in group treated with Tab. Misoprostol 600mcg and Inj. Oxytocin and was found to be statistically significant. Preoperative administration of misoprostol per rectal route and oxytocin infusion after the cesarean section have shown, a better control of bleeding and maintenance of hemoglobin level when compared to oxytocin infusion alone. Thus, instead of oxytocin monotherapy combined use of misoprostol and oxytocin would be more effective in prevention of PPH.

: The drug resistance confronts chemotherapy of neoplasm and microbial infections. A vast array of molecular mechanisms was implicated in drug resistance, including, generation of drug efflux transporters, mutation of drug targets, and alteration of drug metabolism. With the alarming rate of increase in drug resistance, pathogens are bolstering in such a way that many new drugs face efficacy problems within a short span of entry into the market. Evolution is the driving force towards the development of drug resistance. By adopting the modern genomic and functionomic analytical techniques, scientists have now identified novel genes and signalling proteins involved in the evolution of drug resistance in microorganisms. Given the current knowledge of bacterial evolution, the antibiotic drug discovery is ready for a paradigm shift to explore the newer ways to tackle drug resistance. The article discusses such recent developments and reviews their merits and demerits in an attempt to envisage the findings in this new domain of medicine.