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Review
. 2024 Jan 12:14:1305294.
doi: 10.3389/fphar.2023.1305294. eCollection 2023.

Antibiotic action and resistance: updated review of mechanisms, spread, influencing factors, and alternative approaches for combating resistance

Esraa M Halawa  1 , Mohamed Fadel  2 , Mohammed W Al-Rabia  3   4 , Ali Behairy  5 , Nehal A Nouh  6   7 , Mohamed Abdo  8   9 , Rada Olga  10 , Liana Fericean  10 , Ahmed M Atwa  11 , Mohammad El-Nablaway  12   13 , Ahmed Abdeen  14
Affiliations
Review

Antibiotic action and resistance: updated review of mechanisms, spread, influencing factors, and alternative approaches for combating resistance

Esraa M Halawa et al. Front Pharmacol. .

Abstract

Antibiotics represent a frequently employed therapeutic modality for the management of bacterial infections across diverse domains, including human health, agriculture, livestock breeding, and fish farming. The efficacy of antibiotics relies on four distinct mechanisms of action, which are discussed in detail in this review, along with accompanying diagrammatic illustrations. Despite their effectiveness, antibiotic resistance has emerged as a significant challenge to treating bacterial infections. Bacteria have developed defense mechanisms against antibiotics, rendering them ineffective. This review delves into the specific mechanisms that bacteria have developed to resist antibiotics, with the help of diagrammatic illustrations. Antibiotic resistance can spread among bacteria through various routes, resulting in previously susceptible bacteria becoming antibiotic-resistant. Multiple factors contribute to the worsening crisis of antibiotic resistance, including human misuse of antibiotics. This review also emphasizes alternative solutions proposed to mitigate the exacerbation of antibiotic resistance.

Keywords: antibiotic resistance; antibiotics; antimicrobial; bacteria; disease spreading.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Mechanism of DNA replication process and mechanism of action of antibiotics that inhibit DNA replication.
FIGURE 2
FIGURE 2
Mechanism of protein biosynthesis process and mechanism of action of antibiotics that inhibit protein biosynthesis.
FIGURE 3
FIGURE 3
Mechanism of cell wall synthesis and Mechanism of action of antibiotics that inhibit cell wall synthesis.
FIGURE 4
FIGURE 4
Mechanism of action of antibiotics that inhibit folic acid metabolism.
FIGURE 5
FIGURE 5
Mechanism of antibiotic resistance by decreasing antibiotic entry into the bacterial cell.
FIGURE 6
FIGURE 6
Mechanism of antibiotic resistance by increasing antibiotic exit from the bacterial cell.
FIGURE 7
FIGURE 7
Mechanism of antibiotic resistance by alteration in 50 s ribosomal subunit.
FIGURE 8
FIGURE 8
Mechanism of antibiotic resistance by alteration in penicillin-binding protein.
FIGURE 9
FIGURE 9
Mechanism of antibiotic resistance by alteration in DNA gyrase and topoisomerase IV.
FIGURE 10
FIGURE 10
Mechanism of antibiotic resistance by inactivation of the antibiotic.
FIGURE 11
FIGURE 11
Mechanism of antibiotic resistance spread among bacteria by conjugation and transformation.
See this image and copyright information in PMC

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