Antibiotic Adjuvants: Diverse Strategies for Controlling Drug‐Resistant Pathogens

TLDR

The rise of multi‑drug‑resistant bacterial pathogens and the lack of new broad‑spectrum antibiotics in four decades threaten global health. This review investigates adjunctive therapeutic strategies that could be combined with existing antibiotics to extend their effectiveness. The authors examine antiresistance agents, antivirulence drugs, host‑directed therapies, and alternative approaches such as oral rehydration, phage therapy, and probiotics. These diverse strategies show promise and warrant further study to address the impending post‑antibiotic era.

Abstract

The growing number of bacterial pathogens that are resistant to numerous antibiotics is a cause for concern around the globe. There have been no new broad‐spectrum antibiotics developed in the last 40 years, and the drugs we have currently are quickly becoming ineffective. In this article, we explore a range of therapeutic strategies that could be employed in conjunction with antibiotics and may help to prolong the life span of these life‐saving drugs. Discussed topics include antiresistance drugs, which are administered to potentiate the effects of current antimicrobials in bacteria where they are no longer (or never were) effective; antivirulence drugs, which are directed against bacterial virulence factors; host‐directed therapies, which modulate the host's immune system to facilitate infection clearance; and alternative treatments, which include such therapies as oral rehydration for diarrhea, phage therapy, and probiotics. All of these avenues show promise for the treatment of bacterial infections and should be further investigated to explore their full potential in the face of a postantibiotic era.