review · Frontiers in Microbiology
Bacterial drug resistance remains a significant worldwide health concern, intensified by antibiotic usage during the COVID-19 pandemic. Although overall consumption has fallen, global usage remains high, and disparities in national action plans affect low- and middle-income countries. Environments including farms, hospitals, agricultural sites, and wastewater treatment plants serve as reservoirs for resistant bacteria and resistance genes. Emerging interventions focus on restoring the gut microbiome and curbing resistance genes through dietary adjustments and probiotic supplements. Treatment efficacy can also be improved by pairing antibiotics with adjuvants or bacteriophages. Furthermore, new therapeutic options, such as tailored antibiotics, monoclonal antibodies, vaccines, and nanoparticles, present viable alternatives to traditional treatments. Despite progress in genetic sequencing, substantial knowledge gaps remain regarding how gut bacteria regulate resistance, pointing to a need for coordinated policy reforms alongside microbiome-focused interventions.
Antibiotic resistance undermines modern medicine, making common infections harder to treat. Disparities in mitigation plans leave vulnerable regions exposed, while environmental reservoirs accelerate the spread of resistant strains. Identifying alternative therapies, from microbiome management to engineered nanoparticles, helps protect global public health and maintains the effectiveness of essential medical treatments.
The review highlights multiple therapeutic avenues for biotechnology and pharmaceutical developers, including probiotic supplements, bacteriophage-antibiotic combinations, monoclonal antibodies, and nanoparticle-based treatments. These concepts range from early-stage research, such as microbiome-modulating diets and analytical sequencing tools, to applied therapeutic platforms. Health systems and agricultural operators represent potential end users, though specific deployment pathways and regulatory timelines remain unspecified.
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The COVID-19 pandemic underscored bacterial resistance as a critical global health issue, exacerbated by the increased use of antibiotics during the crisis. Notwithstanding the pandemic's prevalence, initiatives to address bacterial medication resistance have been inadequate. Although an overall drop in worldwide antibiotic consumption, total usage remains substantial, requiring rigorous regulatory measures and preventive activities to mitigate the emergence of resistance. Although National Action Plans (NAPs) have been implemented worldwide, significant disparities persist, particularly in low- and middle-income countries (LMICs). Settings such as farms, hospitals, wastewater treatment facilities, and agricultural environments include a significant presence of Antibiotic Resistant Bacteria (ARB) and antibiotic-resistance genes (ARG), promoting the propagation of resistance. Dietary modifications and probiotic supplementation have shown potential in reshaping gut microbiota and reducing antibiotic resistance gene prevalence. Combining antibiotics with adjuvants or bacteriophages may enhance treatment efficacy and mitigate resistance development. Novel therapeutic approaches, such as tailored antibiotics, monoclonal antibodies, vaccines, and nanoparticles, offer alternate ways of addressing resistance. In spite of advancements in next-generation sequencing and analytics, gaps persist in comprehending the role of gut microbiota in regulating antibiotic resistance. Effectively tackling antibiotic resistance requires robust policy interventions and regulatory measures targeting root causes while minimizing public health risks. This review provides information for developing strategies and protocols to prevent bacterial colonization, enhance gut microbiome resilience, and mitigate the spread of antibiotic resistance.
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DOI: 10.3389/fmicb.2025.1517772
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