Antimicrobial resistance during COVID-19 pandemic: alternatives to
combat bacterial infections.
Abstract
The pandemic of antimicrobial resistance with the paucity of new classes
of antibiotics is one of the global threats warranting immediately
actionable strategies. The widespread and inappropriate use of
broad-spectrum and last-resort antibiotics during the first, second and
third waves of the COVID-19 pandemic require a multidisciplinary
approach to address this issue. The current pipeline has only 43
antibiotic candidates targeting the WHO priority pathogens and the
majority are modifications of previously known classes with already
existing cross-resistance. Preserving the power of existing antibiotics
by their regulated use and prevention of the spread of pathogens through
infection prevention and control seems the only possible solution to
defer the AMR crisis. Meanwhile, numerous alternative avenues are
present like antimicrobial peptides, phage therapy, probiotics,
prebiotics and synbiotics, eligo-biotics, phage-endolysins,
anti-virulence therapy, targeting pattern recognition receptors,
phytochemicals, antimicrobial enzymes CRISPR-Cas mediated gene
disruption, efflux pump inhibitor, vaccines, monoclonal and polyclonal
antibodies are currently available to fight antibiotics resistance and
reduce dependence on antibiotics. These alternatives must satisfy the
criteria for safety, efficacy and affordability for translation in
clinical use. This review provides an overview of various promising,
potential and under investigative strategies, as alternatives to
antibiotics, their mechanism of action, current status, challenges in
their commercialization and future scope. Keywords: COVID-19,
antimicrobial resistance, antibiotics, antibiotics alternatives.