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

Jayaseelan Murugaiyan,Thaint Nadi Zaw,Saranya Adukkadukkam,Katia Iskandar,Wireko Andrew Awuah,Esther Patience Nansubuga,Maneesh Paul Satyaseela,Paola Roncada,John P Hays,Natalia Roson-Calero,Nanono Sylvia,Stephen Hawser,Yara Mohsen,Javier Moreno-Morales,Ballamoole Krishna Kumar,G Srinivasa Rao,Rohul Amin,Bruno Tilocca,Arunachalam Kumar ,Maria Josefina Ruiz Alvarez ,Oluwatosin Olugbenga Akinwotu ,Toufik Abdul‐Rahman ,Pradeep Kumar ,Maarten Van Dongen

doi:10.3390/antibiotics11020200

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.

Highlights

Multiple antimicrobials have been developed and marketed over many decades with one common objective–to treat and cure mild to serious infections
In a study to investigate the effect of combining antibiotics and biocides using three antibiotics and seven biocides having different modes of action tested against P. aeruginosa, the results demonstrated different combinations of effects varying between synergism and antagonism [34]
Atmospheric Pressure Non-Thermal Plasma (APNTP) in vitro application for a range of microorganisms indicated that it is effective in the inactivation of bacteria, viruses, fungi, and parasites

Summary

Introduction

Multiple antimicrobials have been developed and marketed over many decades with one common objective–to treat and cure mild to serious infections. Antifungal ( known as anti-mycotic) and anti-parasitic agents have emerged as crucial tools to combat infection. While these antimicrobials have played a critical role in improving our health and life expectancy, their utility has largely been compromised by the emergence of the phenomenon of antimicrobial resistance (AMR) in response to antimicrobials. The WHO has officially recognized that antibiotics and other antimicrobial medications are becoming increasingly ineffective as a result of AMR, and illnesses have become more difficult or even impossible to treat [1] The OIE (World Organization for Animal Health) international committee unanimously adopted the list of Antimicrobial Agents of Veterinary Importance at its 75th general session in May 2007 [2]

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