Futuristic Non-antibiotic Therapies to Combat Antibiotic Resistance: A Review

Abstract

The looming problem of resistance to antibiotics in microorganisms is a global health concern. The drug-resistant microorganisms originating from anthropogenic sources and commercial livestock farming have posed serious environmental and health challenges. Antibiotic-resistant genes constituting the environmental "resistome" get transferred to human and veterinary pathogens. Hence, deciphering the origin, mechanism and extreme of transfer of these genetic factors into pathogens is extremely important to develop not only the therapeutic interventions to curtail the infections, but also the strategies to avert the menace of microbial drug-resistance. Clinicians, researchers and policymakers should jointly come up to develop the strategies to prevent superfluous exposure of pathogens to antibiotics in non-clinical settings. This article highlights the present scenario of increasing antimicrobial-resistance in pathogenic bacteria and the clinical importance of unconventional or non-antibiotic therapies to thwart the infectious pathogenic microorganisms.

Keywords: alternative therapies; antibiotic resistance; drug-resistance; gene transfer; health problems.

FIGURE 1

Country wide Antibiotic consumption rate (in defined daily doses (DD) per 1000 individuals) and Drug Resistance Index (DRI) along with prevalence of antibiotic resistance in some selected countries. [Data for antibiotic consumption rate (up to 2015) and prevalence of antibiotic resistance in the selected countries are retrieved from The Center for Disease Dynamics, Economics and Policy (The Center for Disease Dynamics, 2020). Drug Resistance Index map has been created from the data derived from Klein et al. (2019)].

FIGURE 2

Factors leading to rapid development and use of antibiotics increasing antibiotic-resistance among pathogens, and the routes by which resistant pathogens enter human and animal food chain. Antibiotic-resistant bacteria from humans and animals enter water sources used for drinking or irrigation. Residual antibiotics released from industries alter the natural soil and water microbiota.

FIGURE 3

Alternative non-antibiotic strategies to prevent antimicrobial-resistant infections in animals and humans. Probiotics and phages act as microbiome-modifying therapies to defend against drug-resistant pathogens. Healthy people, healthy animals and healthy environment constitute as One Health Concept to keep environment healthy (P, prebiotics; D, designer or engineered probiotics; M, microbial metabolites; FMT, fecal microbiota transplantation).