A Comprehensive Overview of Antibacterial Agents for Combating Multidrug-Resistant Bacteria: The Current Landscape, Development, Future Opportunities, and Challenges

<b>Background/Objectives:</b> Antimicrobial resistance poses a major public health challenge. The World Health Organization has identified 15 priority pathogens that require prompt development of new antibiotics. This review systematically evaluates the antibacterial resistance of the mo...

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Main Authors: Ina Gajic, Nina Tomic, Bojana Lukovic, Milos Jovicevic, Dusan Kekic, Milos Petrovic, Marko Jankovic, Anika Trudic, Dragana Mitic Culafic, Marina Milenkovic, Natasa Opavski
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Language:English
Published: MDPI AG 2025-02-01
Series:Antibiotics
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Online Access:https://www.mdpi.com/2079-6382/14/3/221
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author Ina Gajic
Nina Tomic
Bojana Lukovic
Milos Jovicevic
Dusan Kekic
Milos Petrovic
Marko Jankovic
Anika Trudic
Dragana Mitic Culafic
Marina Milenkovic
Natasa Opavski
author_facet Ina Gajic
Nina Tomic
Bojana Lukovic
Milos Jovicevic
Dusan Kekic
Milos Petrovic
Marko Jankovic
Anika Trudic
Dragana Mitic Culafic
Marina Milenkovic
Natasa Opavski
author_sort Ina Gajic
collection DOAJ
description <b>Background/Objectives:</b> Antimicrobial resistance poses a major public health challenge. The World Health Organization has identified 15 priority pathogens that require prompt development of new antibiotics. This review systematically evaluates the antibacterial resistance of the most significant bacterial pathogens, currently available treatment options, as well as complementary approaches for the management of infections caused by the most challenging multidrug-resistant (MDR) bacteria. For carbapenem-resistant Gram-negative bacteria, treatment options include combinations of beta-lactam antibiotics and beta-lactamase inhibitors, a novel siderophore cephalosporin, known as cefiderocol, as well as older antibiotics like polymixins and tigecycline. Treatment options for Gram-positive bacteria are vancomycin, daptomycin, linezolid, etc. Although the development of new antibiotics has stagnated, various agents with antibacterial properties are currently in clinical and preclinical trials. Non-antibiotic strategies encompass antibiotic potentiators, bacteriophage therapy, antivirulence therapeutics, antimicrobial peptides, antibacterial nanomaterials, host-directed therapy, vaccines, antibodies, plant-based products, repurposed drugs, as well as their combinations, including those used alongside antibiotics. Significant challenges exist in developing new antimicrobials, particularly related to scientific and technical issues, along with policy and economic factors. Currently, most of the alternative options are not part of routine treatment protocols. <b>Conclusions and Future Directions:</b> There is an urgent need to expedite the development of new strategies for treating infections caused by MDR bacteria. This requires a multidisciplinary approach that involves collaboration across research, healthcare, and regulatory bodies. Suggested approaches are crucial for addressing this challenge and should be backed by rational antibiotic use, enhanced infection control practices, and improved surveillance systems for emerging pathogens.
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spelling doaj-art-40d001453abc49e0b92eaecef7964eff2025-08-20T02:42:41ZengMDPI AGAntibiotics2079-63822025-02-0114322110.3390/antibiotics14030221A Comprehensive Overview of Antibacterial Agents for Combating Multidrug-Resistant Bacteria: The Current Landscape, Development, Future Opportunities, and ChallengesIna Gajic0Nina Tomic1Bojana Lukovic2Milos Jovicevic3Dusan Kekic4Milos Petrovic5Marko Jankovic6Anika Trudic7Dragana Mitic Culafic8Marina Milenkovic9Natasa Opavski10Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaGroup for Biomedical Engineering and Nanobiotechnology, Institute of Technical Sciences of SASA, Kneza Mihaila 35/IV, 11000 Belgrade, SerbiaAcademy of Applied Studies Belgrade, College of Health Sciences, 11000 Belgrade, SerbiaInstitute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaInstitute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaUniversity Clinical Hospital Center “Dr. Dragisa Misovic-Dedinje”, 11040 Belgrade, SerbiaInstitute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaFaculty of Medicine, University of Novi Sad, 21000 Novi Sad, SerbiaFaculty of Biology, University of Belgrade, 11000 Belgrade, SerbiaDepartment of Microbiology and Immunology, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, SerbiaInstitute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia<b>Background/Objectives:</b> Antimicrobial resistance poses a major public health challenge. The World Health Organization has identified 15 priority pathogens that require prompt development of new antibiotics. This review systematically evaluates the antibacterial resistance of the most significant bacterial pathogens, currently available treatment options, as well as complementary approaches for the management of infections caused by the most challenging multidrug-resistant (MDR) bacteria. For carbapenem-resistant Gram-negative bacteria, treatment options include combinations of beta-lactam antibiotics and beta-lactamase inhibitors, a novel siderophore cephalosporin, known as cefiderocol, as well as older antibiotics like polymixins and tigecycline. Treatment options for Gram-positive bacteria are vancomycin, daptomycin, linezolid, etc. Although the development of new antibiotics has stagnated, various agents with antibacterial properties are currently in clinical and preclinical trials. Non-antibiotic strategies encompass antibiotic potentiators, bacteriophage therapy, antivirulence therapeutics, antimicrobial peptides, antibacterial nanomaterials, host-directed therapy, vaccines, antibodies, plant-based products, repurposed drugs, as well as their combinations, including those used alongside antibiotics. Significant challenges exist in developing new antimicrobials, particularly related to scientific and technical issues, along with policy and economic factors. Currently, most of the alternative options are not part of routine treatment protocols. <b>Conclusions and Future Directions:</b> There is an urgent need to expedite the development of new strategies for treating infections caused by MDR bacteria. This requires a multidisciplinary approach that involves collaboration across research, healthcare, and regulatory bodies. Suggested approaches are crucial for addressing this challenge and should be backed by rational antibiotic use, enhanced infection control practices, and improved surveillance systems for emerging pathogens.https://www.mdpi.com/2079-6382/14/3/221antimicrobial resistancemultidrug resistancenew antibioticstreatment options
spellingShingle Ina Gajic
Nina Tomic
Bojana Lukovic
Milos Jovicevic
Dusan Kekic
Milos Petrovic
Marko Jankovic
Anika Trudic
Dragana Mitic Culafic
Marina Milenkovic
Natasa Opavski
A Comprehensive Overview of Antibacterial Agents for Combating Multidrug-Resistant Bacteria: The Current Landscape, Development, Future Opportunities, and Challenges
Antibiotics
antimicrobial resistance
multidrug resistance
new antibiotics
treatment options
title A Comprehensive Overview of Antibacterial Agents for Combating Multidrug-Resistant Bacteria: The Current Landscape, Development, Future Opportunities, and Challenges
title_full A Comprehensive Overview of Antibacterial Agents for Combating Multidrug-Resistant Bacteria: The Current Landscape, Development, Future Opportunities, and Challenges
title_fullStr A Comprehensive Overview of Antibacterial Agents for Combating Multidrug-Resistant Bacteria: The Current Landscape, Development, Future Opportunities, and Challenges
title_full_unstemmed A Comprehensive Overview of Antibacterial Agents for Combating Multidrug-Resistant Bacteria: The Current Landscape, Development, Future Opportunities, and Challenges
title_short A Comprehensive Overview of Antibacterial Agents for Combating Multidrug-Resistant Bacteria: The Current Landscape, Development, Future Opportunities, and Challenges
title_sort comprehensive overview of antibacterial agents for combating multidrug resistant bacteria the current landscape development future opportunities and challenges
topic antimicrobial resistance
multidrug resistance
new antibiotics
treatment options
url https://www.mdpi.com/2079-6382/14/3/221
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