Review of alternative antimicrobial therapies

Antimicrobial resistance is a most challenging global public health problem. Today, the number of antibiotic-resistant bacterial strains has been increasing to the point of economic and social disaster. Thus, it is necessary to find alternative effective approaches to antimicrobial therapy and prevention. The most promising alternative antimicrobial therapies include antibodies; bacteriophages and bacteriophage-derived enzymes; antivirulence agents; probiotics and microbiome-modulating agents; immunostimulants; host-protective antimicrobial peptides; nanoparticles and liposomes, etc. A comprehensive approach to treating infections without exacerbating the antimicrobial resistance problem provides for combining these alternative treatments with strategies to maintain the efficacy of existing antimicrobial agents. The review is aimed to summarize data on the causes and mechanisms underlying the development of resistance; limitations of standard treatments; alternative resistance-inhibiting treatments, their advantages and disadvantages; and future challenges. The paper presents summary of alternative antimicrobial agents at different stages of pharmaceutical development.