Emerging global trends in next-generation alternatives to classic antibiotics for combatting multidrug-resistant bacteria

The issue of antibiotic resistance by pathogenic bacteria is considered one of the major global threats to current public health. The need to find solutions to this problem is driving the development of new therapies as alternatives to the use of conventional antibiotics. For this reason, the number of research studies and published works on this topic has increased significantly in recent years. The present study aims to analyze global scientific production data regarding the development of new therapies as alternatives to the use of conventional antibiotics, with the goal of determining the latest trends in the field and facilitating the creation of effective alternatives. A total of 47,702 studies have been published in just 13 years (2010–2023), a massive quantity surpassed only by research related to the recent COVID-19 pandemic, demonstrating the current state of health urgency. The United States and China lead the research efforts in terms of institutions, authors, and journals, demonstrating intense collaboration between two of the world's leading economic powers. Antimicrobial peptides (AMPs), nanotechnology, plant-based methods, phage therapy, probiotics, vaccines, or antibodies are being more extensively investigated compared to other more novel alternatives including bacteriocins and CRISPR-based therapies. Our results indicate that most of the studied alternatives are used in combination to enhance treatment efficacy. Specifically, many of them are focused on preventing the development of biofilms, which appear as the primary virulence agent of resistant pathogenic bacteria. Our results provide new data that may help in the search for novel alternatives or in improving current treatments for the development of an effective solution. In addition, our data can also be of great assistance in promoting international collaboration between countries and institutions with greater experience in the field. • USA and China lead research efforts on antibiotic alternatives. • Antimicrobial peptides and nanoparticles are being more extensively investigated. • Most of the studied alternatives are used in combination to enhance treatment efficacy. • Novel alternatives are not exclusively being studied for antibiotic resistance. • Biofilms are one of the most studied targets against resistant bacteria.