review · Frontiers in Pharmacology
Bacterial resistance to antibacterial medications presents an ongoing threat to modern healthcare and routine infection management. Resistance develops through diverse biological mechanisms, including the enzymatic inactivation of drugs, structural modifications at drug target sites, reduced drug influx, and the active clearance of compounds via efflux pumps. Bacteria also rely on biofilm formation and horizontal gene transfer to protect themselves and disseminate resistance traits across populations. Addressing this growing challenge requires both systematic intervention programmes and the development of next-generation antimicrobial treatments. By collating evidence on resistance pathways and control measures, the synthesis provides insights intended to assist future research directions and inform antimicrobial stewardship programmes.
Antibacterial resistance undermines standard medical treatments by rendering existing drugs ineffective against common bacterial infections. By outlining the primary ways bacteria evade treatments, along with potential countermeasures and emerging therapeutics, this work clarifies the core operational barriers healthcare systems must navigate to sustain effective infection control.
The work synthesises knowledge to inform the development of next-generation antimicrobials and therapeutic interventions. Primary users include pharmaceutical researchers, drug developers, and antimicrobial stewardship teams seeking to bypass mechanisms like efflux pumps, target modifications, or biofilms. As a literature review, it remains at the conceptual and early-stage research level, offering a reference baseline rather than presenting a directly tested product or near-market asset.
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Antibacterial drug resistance poses a significant challenge to modern healthcare systems, threatening our ability to effectively treat bacterial infections. This review aims to provide a comprehensive overview of the types and mechanisms of antibacterial drug resistance. To achieve this aim, a thorough literature search was conducted to identify key studies and reviews on antibacterial resistance mechanisms, strategies and next-generation antimicrobials to contain antimicrobial resistance. In this review, types of resistance and major mechanisms of antibacterial resistance with examples including target site modifications, decreased influx, increased efflux pumps, and enzymatic inactivation of antibacterials has been discussed. Moreover, biofilm formation, and horizontal gene transfer methods has also been included. Furthermore, measures (interventions) taken to control antimicrobial resistance and next-generation antimicrobials have been discussed in detail. Overall, this review provides valuable insights into the diverse mechanisms employed by bacteria to resist the effects of antibacterial drugs, with the aim of informing future research and guiding antimicrobial stewardship efforts.
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DOI: 10.3389/fphar.2024.1444781
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