Harnessing Non-Antibiotic Strategies to Counter Multidrug-Resistant Clinical Pathogens with Special Reference to Antimicrobial Peptides and Their Coatings

Antimicrobial resistance is a global issue, with antibiotic misuse leading to resistant microbes. Alternative antimicrobial strategies, including bacteriophage therapy, probiotics, immunotherapies, photodynamic therapy, essential oils, nanoparticles, and antimicrobial peptides (AMPs), are being explored. AMPs have shown promise against bacteria, viruses, fungi, and parasites, but their application in mainstream drug development faces challenges like low bioavailability and potential toxicity. Advancements in peptide engineering and chemical modifications offer solutions to enhance their clinical utility. Peptideomimetics, which have shown effective activity against a broad range of pathogens, are being developed to improve the cost, stability, and selective toxicity of AMPs. Comprehensive in vivo studies are recommended to evaluate the efficacy of AMPs and their mimetics, investigate synergistic combinations, and assess their potential as medical device coatings.