Buzz Mingin

Antibiotic resistance, defined as the distinct ability of the bacterial pathogens to render antibiotics ineffective against them, has assumed a critical level globally. The ongoing COVID-19 pandemic has further accelerated it. According to conservative estimates, 10 million people annaly  are likely to succumb to ABR by 2050  if it remains uncontrolled.

Discovery, research and development of newer antibiotics from novel classes is the ideal way forward. However, owing to several bottlenecks, this is not in sight in the near future. Meanwhile, therefore, it should be in place to consider, over and above vaccines, nonantibiotic strategies  for controlling infectious diseases. 

The  pathogen-specific antibodies (passive immunization), administered before or after exposure to the pathogens, may well be a effective therapy. Though virtually abandoned over the past 8-9 decades, now that the available antibiotics are becoming ineffective, it is beginning to gain attention as an alternative to chemical/conventional antibiotics.

         Bacteriophages are viruses that infect bacteria, which potentially could be utilized for therapeutic purposes. Bacteriophage (also termed “phage”) therapy ranks among the most actively researched alternatives to antibiotics.However, there are numerous obstacles that need to be circumvented before these or other alternatives could substitute antibiotics, or even reach the market.

Immunotherapyinvolves molecules that boost the host immune system to generally prevent disease in the course of infection-prone times

Probiotics (also prebiotics and synbiotics) are good bacteria that are supposed to modulate the gut microbial community toward health. However, some reports indicate lack of consistent efficacy. Clearly, more work is required to demonstrate their role as an alternative to antibiotics.

Fecal microbiota transplant therapy is an effective option for therapy of recurrent infection with Clostridium difficile. Presently, its use in other indications needs to be a part of clinical trials.

Probiotics , prebiotics and synbiotics have shown good evidence favouring their usefulness aas adjuvant therapy in bacterial infections though , as yet there is hardly any convincing evidence of their usefulness as an alternative to antibiotics.

Antimicrbial Peptides as antimicrobial peptides in defense against intruding pathogens.  in human medicine is being evaluated. Antimicrobial peptides/ proteins (ABPs) have broad activity to directly kill pathogens.

Oligonucleotide therapy is in the process of research trials as a new approach for the treatment  of MDR pathogens. Recently, work of researchers, There is evidence of the  powerful antimicrobial activity of this lipid oligonucleotide (LON) on the ß-lactamase activity in clinical and laboratory studies. The self-delivery of oligonucleotide sequences via lipid conjugation may be extended to several antibiotics,  opening  up novel ways to tackle the nasty problem of ABR.

In conclusion, though nonantibiotics cannot replace antibiotics, their use merits consideration as adjuvant, complementary or facilitator therapy in infectious diseases causes by bacterial pathogens.

Key Words: Antibiotic resistance; Antibodies; Antinucleotide peptides’ Bactriophage; Immunotherapy;  Nonantibiotics, Oligonucleotides; Probiotics