Progress in Alternative Strategies to Combat Antimicrobial Resistance: Focus on Antibiotics

Abstract

Antibiotic resistance, and, in a broader perspective, antimicrobial resistance (AMR), continues to evolve and spread beyond all boundaries. As a result, infectious diseases have become more challenging or even impossible to treat, leading to an increase in morbidity and mortality. Despite the failure of conventional, traditional antimicrobial therapy, in the past two decades, no novel class of antibiotics has been introduced. Consequently, several novel alternative strategies to combat these (multi-) drug-resistant infectious microorganisms have been identified. The purpose of this review is to gather and consider the strategies that are being applied or proposed as potential alternatives to traditional antibiotics. These strategies include combination therapy, techniques that target the enzymes or proteins responsible for antimicrobial resistance, resistant bacteria, drug delivery systems, physicochemical methods, and unconventional techniques, including the CRISPR-Cas system. These alternative strategies may have the potential to change the treatment of multi-drug-resistant pathogens in human clinical settings.

Silver Nanoparticles Targeting the Drug Resistance Problem of Streptococcus dysgalactiae: Susceptibility to Antibiotics and Efflux Effect

“…Health institutions, the scientific community, and governmental leaders at the local, national, and international levels need to address the importance of finding effective and affordable solutions to combat AMR [ 2 ]. Some alternatives to overcome AMR have been reported [ 5 ]. These alternatives include the use of (1) organic compounds (essential oils, phytochemicals, metabolites from medicinal plants, etc.…”

“…), (2) biomolecules (enzymes, antibodies and bacteriocins), (3) methods such as phage therapy and (4) physicochemical procedures (i.e., non-thermal atmospheric pressure plasmas, photoinactivation, chemotherapy, etc.) [ 5 ]. Usually, organic compounds and biomolecules alone and/or combined with antibiotics show antimicrobial activity with a synergistic effect.…”

“…Usually, organic compounds and biomolecules alone and/or combined with antibiotics show antimicrobial activity with a synergistic effect. However, these molecules are expensive and have a low storage stability [ 5 ]. Regarding phage therapy and physicochemical procedures, they are laborious, requiring sophisticated equipment and highly qualified personnel.…”

Extraintestinal Pathogenic Escherichia coli: Beta-Lactam Antibiotic and Heavy Metal Resistance

“…Actually, NPs are increasingly used as a delivery system for medical products, including antibiotics, or directly as antibacterial agents. Although the exact mechanism through which NPs exert their antimicrobial activity is not completely understood, metal and metal oxide NPs have been shown to have many useful features, such as to modify both the toxicity and the antibacterial activity of antibiotics; to damage the bacterial outer membrane and/or cell wall; to favor the interaction between intra-and extracellular components and ions; to produce reactive oxygen species that damage bacterial structures; to inhibit DNA synthesis; to inhibit enzyme activity [133,134].…”

Antimicrobial Resistance Development Pathways in Surface Waters and Public Health Implications

“…Antimicrobial resistance (AR) in the environment is one of the emerging threats to public health globally. The total number of annual deaths caused by antimicrobial-resistant pathogen-related infections is estimated to increase from 700,000 to 10 million by 2050 with a USD 100 trillion cost worldwide [ 1 ]. In the United States alone, antibiotic-resistant pathogens cause about 2.8 million illnesses and 35,000 deaths annually [ 2 , 3 , 4 ].…”