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Bacterial resistance is rapidly developing; therefore, many critically important pharmaceuticals have begun to become obsolete. It is necessary to know that if these pharmaceuticals are not used cautiously, devastating results await us.

In April 2014, the World Health Organization (WHO) called the fight against antibiotic resistance an “important action” and strongly warned authorities against unconscious approaches; it explained how antibiotics should be produced and what new approaches are needed in terms of prescription and use.

In response, microbiologists have put forth and continue to put forth their efforts to develop new drugs or new methods to combat infection. Unfortunately, these search for solutions are still in the development phase.

Vaccination

Using vaccines instead of drug treatment prevents infections caused by pathogens such as viruses and bacteria. Vaccines imitate a pathogen or a disease and ensure that the body creates a response when it encounters this pathogen in the future. However, since it would be costly when applied to the entire population, this situation limits its use. In some countries, storing vaccines at appropriate temperatures, which brings with it many complications, is problematic.

In addition, the number of diseases that can be prevented with vaccines is also limited. Regardless of the possible complications, many scientific communities see vaccines as playing a leading role in the future prudent use of antibiotics. At the same time, both animal and human health research groups are working hard to develop new and innovative vaccine technologies and platforms.

Types of vaccines

Vaccines produced from live, dead or inactivated pathogens neutralize toxins or pathogen segments. The table shows some of the important types of vaccines used in modern science.

Probiotics

Beneficial bacteria are used because they work on the competitive exclusion principle, first described by Nurmi and Rantala in 1973. This helps reduce the number of harmful bacteria in the digestive tract, where non-pathogenic bacteria colonize.

Scientists are only beginning to understand the wide range of bacterial species in the gastrointestinal tract and their effects on humans and animals. The term probiotic was first used by Lilly and Stillwell (1965) and has been adapted to mean that the microorganism behaves in a way that is beneficial to the host. Single or multiple strains can be used; the most abundant bacterial species in poultry feed can be combined.

Bacterial species; Bacillus, E. coli, Lactobacillus, Lactococcus, many yeast species and Streptecoccus.

Probiotics also take on an indigestible structure when introduced into helpful bacteria and beneficial microorganisms.

• Positive aspects: Intestinal health is improved and maintained. Pathogen colonization is prevented. There is no excretion period.

• Negative aspects: There is mixed activity in a single probiotic.

Phage therapy (Bacteriophage)

Phages are viruses that invade bacterial cells and disrupt their metabolism, thus lysing (killing) them. Phage therapy was used in Eastern Europe and Russia to treat foodborne pathogens that have passed from animals and plants to humans. One feature of phage therapy is that it is used for bacteria used to produce endolysins and exolysins. The enzymes produced by phages disrupt the structure and shape of the walls that protect bacteria from external factors (peptidoglycan structure) and cause them to break down. A wide range of studies have shown that while exolysins are secreted, endolysins function inside the bacteria and destroy them.

Exolysins are secreted from eukaryotic cells. We can give examples of lysozymes, which have antibacterial properties found in tears and saliva. Exolysins fulfill their function by preventing the shape and function of the pepticoglycan wall, which acts as a protective barrier on the bacterial wall.

• Positive aspects: Target-specific phages can be used in combination to minimize the development of resistance. It is believed that topical applications are particularly much more effective. There is no harm in using them together with antibiotics.

• Negative aspects: Resistance may develop. Due to their specificity, problems may occur with the subtypes of bacteria.

Antibiotics with a strengthening effect

Let's put aside alternative antimicrobial agents. There are many ways to increase antibiotic dose efficiency; by using antibiotic combinations, by blocking resistance in molecules and genes, and by using the synergistic effects of non-antibiotics.

These are substances known as adjuvants, which have the properties to reject the resistance mechanism that exists in some bacteria against beta-lactams. Adjuvants have developed in recent years and should not be ignored. Beta-lactamases are enzymes produced by bacteria and create bacterial resistance.

For example, when penicillin-type beta-lactams are applied, amoxicillin was given with clavulanic acid. The acid worked as an adjuvant and blocked the beta-lactamase enzyme. There are also many ways to prevent resistance; some bacteria pump drugs out of the membrane with a mechanism known as the bacterial leakage pump.

Leakage pump inhibitors are being analyzed in humans and animals. One of the aims of the analyzes is to find the inhibitor of Campylobacter jejuni, a foodborne pathogen in humans and transmitted from chickens. In addition, currently available antibiotics must be used consciously. Choosing the right antibiotic for possible infections is possible with diagnostic tests. For this reason, the decision to use antibiotics should be made under the supervision of a physician. With these measures, we can help protect the antibiotic portfolio we have.

A new beginning?

Effective new treatments are possible against some difficult bacterial strains that mutate and form a protective layer on their outer layer. Teixobactin, discovered by microbiologists at Northeastern University in the USA, has been accepted all over the world. Teixobactin works in harmony with mammalian cells and attacks gram-positive pathogens such as Staphylococcus (MRSA), Enterococci and Mycobacterium tuberculosis.

The recently discovered new method that works by creating an ideal bacterial environment, the miniature device called iChip, is a remarkable invention. iChip makes it easier for single cells to grow by isolating them in the natural environment. Scientists continue to work on more microorganisms to obtain official permits. This will lead to other drug discoveries. Bacteria that can grow without culture allow scientists to analyze many unused microbes, and this use will be a good guide in solving the health crisis.

Predatory bacteria

A new and interesting alternative to antibiotics, predatory bacteria work by hunting for nutrients and energy. The most promising predatory bacteria are Bdellovibrio and BALO, which is used to destroy Gram-negative bacteria. Predatory bacteria are known for their attack on biofilms (a cluster of microorganisms in which cells adhere to each other and/or to the surface on which they are located. These attached cells are usually embedded in an extracellular polymeric substance produced by themselves. This polymeric substance has a complex structure consisting of DNA, proteins and polysaccharides). Biofilm bacteria are more resistant to antibiotics. In such cases, the use of predatory bacteria will bring positive results in treatment.