Abstract
Antibiotics are one of the greatest medical advances of the 20th century, however, they are quickly becoming useless due to antibiotic resistance that has been augmented by poor antibiotic stewardship and a void in novel antibiotic discovery. Few novel classes of antibiotics have been discovered since 1960, and the pipeline of antibiotics under development is limited. We therefore are heading for a post-antibiotic era in which common infections become untreatable and once again deadly. There is thus an emergent need for both novel classes of antibiotics and novel approaches to treatment, including the repurposing of existing drugs or preclinical compounds and expanded implementation of combination therapies. In this review, we highlight to utilize alternative drug targets/therapies such as combinational therapy, anti-regulator, anti-signal transduction, anti-virulence, anti-toxin, engineered bacteriophages, and microbiome, to defeat antibiotic-resistant bacteria.
Highlights
With the global misuse of antibiotics, the rapid emergence and dissemination of antibiotic-resistant bacteria has been increasing yearly [1]
Dissanayake et al revealed that a multi-target phage-cocktail significantly reduced the levels of an enterohemorrhagic E. coli O157:H7 strain in infected mice and the effectiveness was approximately the same at that observed with ampicillin treatment [120]
Antibiotic resistance is dramatically increased worldwide in the past decades and these superbugs bring us to the end of current “antibiotic era”
Summary
With the global misuse of antibiotics, the rapid emergence and dissemination of antibiotic-resistant bacteria has been increasing yearly [1]. Compared with patients infected with non-ESKAPE pathogens, patients presenting ESPAKE-bloodstream infections were associated with a 3.3-day increase in length of hospital stay, and a 2.1% absolute increase in mortality [5]. It has become critically challenging for clinicians to treat patients infected with multidrug resistant (MDR), extensively resistant (XDR), or pandrug resistant (PDR) bacteria. Patients infected with antibiotic-resistant bacteria acquire delayed antimicrobial therapy, the chance of successful clinical treatment deteriorates regardless of the origin of the patient or bacterial species [7,8]. We highlight the alternative drug targets and therapies to defeat antibiotic-resistant bacteria
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