Welcome to the emerging third era of antimicrobial therapy

Abstract

Problem otpornosti mikroba na antibiotike može se sagledati kao globalni, kompleksan i sistemski problem s društvenim, kulturnim, socijalnim i političkim posljedicama. Nekoliko je strategija kako prevladati otpornost mikroba na antibiotike, no danas postoji potreba za globalnom strategijom u solidarnoj borbi protiv ove sporo-razvijajuće i progresivne nepogode. Budući da na sve uključene dionike u ovom dinamičnom procesu postoji javni pritisak, ujedno je taj pritisak usmjeren i na znanstvenu zajednicu. Odgovor je na povratak na specifičnu terapiju putem primjene terapijskih monoklonalnih protutijela, ali i primjene inhibitora mikrobne virulencije, bakteriofagnih lizina, antimikrobnih peptida, potencijatora učinka antibiotika, imunomodulatora i dr. Ti pristupi, od kojih je većina orjentirana mikrobno-specifično, uvode nas u treće doba antimikrobne terapije koje se polako rađa napuštajući dominaciju antibiotske molekularne paradigme.The problem of antimicrobial resistance (AMR) could be seen as a global, complex and systemic problem with social, cultural and political consequences. There are several strategies how to overcome AMR, but today we need a unique global and solidary strategy to combat this slowly emerging and progressive disaster. Because all stakeholders in this dynamic challenging process are involved, scientists are also under public pressure to resolve this problem. Nowadays, scientific approach to combat AMR is focused on the need for a specific therapy. This approach includes the use of therapeutic monoclonal antibodies, microbial virulence inhibitors, bacteriophage lysins, antimicrobial proteins, potentiators of current antibiotics, immunomodulators, etc. These approaches, most of which are microbe-specific oriented, introduce us to the third era of antimicrobial therapy, which slowly arises from the domination of molecular paradigmatic era of antibiotics