Yarahmadi Aref, Najafiyan Hamide, Yousefi Mohammad Hasan, Khosravi Elham, Shabani Ehsan, Afkhami Hamed, Aghaei Seyed Soheil
Department of Biology, Khorramabad Branch, Islamic Azad University, Khorramabad, Iran.
Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Front Cell Infect Microbiol. 2025 Mar 18;15:1493915. doi: 10.3389/fcimb.2025.1493915. eCollection 2025.
Antibiotics represent one of the most significant medical breakthroughs of the twentieth century, playing a critical role in combating bacterial infections. However, the rapid emergence of antibiotic resistance has become a major global health crisis, significantly complicating treatment protocols. This paper provides a narrative review of the current state of antibiotic resistance, synthesizing findings from primary research and comprehensive review articles to examine the various mechanisms bacteria employ to counteract antibiotics. One of the primary sources of antibiotic resistance is the improper use of antibiotics in the livestock industry. The emergence of drug-resistant microorganisms from human activities and industrial livestock production has presented significant environmental and public health concerns. Today, resistant nosocomial infections occur following long-term hospitalization of patients, causing the death of many people, so there is an urgent need for alternative treatments. In response to this crisis, non-antibiotic therapeutic strategies have been proposed, including bacteriophages, probiotics, postbiotics, synbiotics, fecal microbiota transplantation (FMT), nanoparticles (NPs), antimicrobial peptides (AMPs), antibodies, traditional medicines, and the toxin-antitoxin (TA) system. While these approaches offer innovative solutions for addressing bacterial infections and preserving the efficacy of antimicrobial therapies, challenges such as safety, cost-effectiveness, regulatory hurdles, and large-scale implementation remain. This review examines the potential and limitations of these strategies, offering a balanced perspective on their role in managing bacterial infections and mitigating the broader impact of antibiotic resistance.
抗生素是20世纪最重要的医学突破之一，在对抗细菌感染方面发挥着关键作用。然而，抗生素耐药性的迅速出现已成为全球主要的健康危机，使治疗方案变得极为复杂。本文对当前抗生素耐药性的现状进行了叙述性综述，综合了原始研究和全面综述文章的研究结果，以探讨细菌对抗抗生素所采用的各种机制。抗生素耐药性的主要来源之一是畜牧业中抗生素的不当使用。人类活动和工业化畜牧生产中产生的耐药微生物对环境和公共卫生构成了重大威胁。如今，患者长期住院后会发生耐药性医院感染，导致许多人死亡，因此迫切需要替代治疗方法。针对这一危机，人们提出了非抗生素治疗策略，包括噬菌体、益生菌、后生元、合生元、粪便微生物群移植（FMT）、纳米颗粒（NPs）、抗菌肽（AMPs）、抗体、传统药物以及毒素-抗毒素（TA）系统。虽然这些方法为解决细菌感染和保持抗菌治疗的有效性提供了创新解决方案，但仍存在安全性、成本效益、监管障碍和大规模实施等挑战。本综述探讨了这些策略的潜力和局限性，对它们在管理细菌感染和减轻抗生素耐药性更广泛影响方面的作用提供了一个平衡的观点。
