Encountering antibiotic resistance: Current challenges and emerging solutions in the post-antibiotic era

Abstract

Antibiotic resistance has become one of the greatest threats to global health in this century, causing many health problems in many countries. In contrast, the multidrug-resistant (MDR) bacterial strains developed mechanisms to encounter surrounding toxic compounds in their environments, making their treatment more difficult. Moreover, these pathogens possess different resistance, which allows them to survive and proliferate in hostile environments. Amid delays in the discovery of new antibiotics because many medical companies withdrew their research into new treatments due to financial unviability, many scientists resorted to searching for innovative new strategies to counter the antibiotic resistance and restore and extend the efficacy of existing treatments. This review discussed some of these strategies, like combining antibiotics with non-antibiotics as adjuvants to get synergistic activities that disrupt bacterial defenses; the use of targeted inhibitors to suppress the core functions of pathogens; the use of bacteriophages as precision vectors to directly target specific targets within bacterial cells; the use of antimicrobial peptides as adjuvant therapies to increase membrane permeability and facilitate the intracellular entry of co-administered therapeutic agents; the development of vaccines, thereby reducing therapeutic dependency on conventional antimicrobials. On the other hand, the review discussed the latest technologies for detecting resistance in pathogenic bacteria, and artificial intelligence as a novel and promising approach that may enhance the ability to predict resistance patterns and facilitate the design of new drugs with significant effects. Likewise, the One Health strategy was discussed, which is considered optimistically, combines robust global surveillance, responsible antibiotic stewardship, interdisciplinary collaboration, and health-in-all-policies to achieve better public health outcomes, mitigate the expanding threat and safeguard public health for the future worldwide.