Russian MedicineRussian MedicineРоссийский медицинский журнал0869-21062412-9100Eco-Vector67861810.17816/medjrf678618ZMZTNLReviewsНаучные обзорыResearch ArticleReview of alternative antimicrobial therapiesОбзор альтернативных средств антимикробной терапииhttps://orcid.org/0009-0005-3367-8883RomanovaSvetlana V.РомановаСветлана Валентиновна
Russian Federation
sromanova@cspfmba.ruhttps://orcid.org/0000-0001-6117-09848311-3717TsypkinaAnastasia V.ЦыпкинаАнастасия Валерьевна
Russian Federation

Cand. Sci. (Pharmacy)

канд. фармацевт. наук

atsypkina@cspfmba.ruhttps://orcid.org/0009-0008-5175-4386SubbotinaTatiana I.СубботинаТатьяна Игоревна
Russian Federation
tsubbotina@cspfmba.ruhttps://orcid.org/0000-0002-7942-8004YudinSergey M.ЮдинСергей Михайлович
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

Yudin@cspfmba.ruhttps://orcid.org/0000-0001-7378-983X7178-5020KeskinovAnton A.КескиновАнтон Артурович
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

Keskinov@cspfmba.ruhttps://orcid.org/0000-0002-1907-00987842-8808MakarovValentin V.МакаровВалентин Валентинович
Russian Federation

Cand. Sci. (Biology)

канд. биол. наук

Makarov@cspfmba.ruhttps://orcid.org/0000-0003-4772-96866642-7819ZagainovaAngelica V.ЗагайноваАнжелика Владимировна
Russian Federation

Cand. Sci. (Biology)

канд. биол. наук

azagaynova@cspfmba.ruhttps://orcid.org/0000-0001-5429-95288453-9166RomanovBoris K.РомановБорис Константинович
Russian Federation

MD, Dr. Sci. (Medicine), Associate Professor

д-р мед. наук, доцент

Romanov_BK@rsmu.ruCentre for Strategic Planning and Management of Biomedical Health Risks of the Federal Medical and Biological AgencyЦентр стратегического планирования и управления медико-биологическими рисками здоровью Федерального медико-биологического агентстваThe Russian National Research Medical University named after N.I. PirogovРоссийский национальный исследовательский медицинский университет имени Н.И. Пирогова17062025110620253132362491604202523052025Copyright ©; 2025, Eco-VectorCopyright ©; 2025, Эко-Вектор2025Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0/https://medjrf.com/0869-2106/article/view/678618

Antimicrobial resistance is a most challenging global public health problem. Today, the number of antibiotic-resistant bacterial strains has been increasing to the point of economic and social disaster. Thus, it is necessary to find alternative effective approaches to antimicrobial therapy and prevention. The most promising alternative antimicrobial therapies include antibodies; bacteriophages and bacteriophage-derived enzymes; antivirulence agents; probiotics and microbiome-modulating agents; immunostimulants; host-protective antimicrobial peptides; nanoparticles and liposomes, etc. A comprehensive approach to treating infections without exacerbating the antimicrobial resistance problem provides for combining these alternative treatments with strategies to maintain the efficacy of existing antimicrobial agents.

The review is aimed to summarize data on the causes and mechanisms underlying the development of resistance; limitations of standard treatments; alternative resistance-inhibiting treatments, their advantages and disadvantages; and future challenges. The paper presents summary of alternative antimicrobial agents at different stages of pharmaceutical development.

Резистентность к противомикробным препаратам — одна из самых сложных проблем мирового здравоохранения. В настоящее время наблюдается рост числа антибиотикорезистентных штаммов бактерий на грани экономической и социальной катастрофы, в связи с чем необходим поиск альтернативных эффективных подходов к антимикробной терапии и профилактике. Наиболее перспективными альтернативными средствами антимикробной терапии являются антитела; бактериофаги и ферменты, полученные из бактериофагов; антивирулентные агенты; пробиотики и микробиом-модулирующие вещества; иммуностимуляторы; антимикробные пептиды, защищающие хозяина; наночастицы и липосомы и т. д. Комплексный подход к лечению инфекций без усугубления проблемы устойчивости к противомикробным препаратам предполагает сочетание этих альтернативных методов лечения со стратегиями сохранения эффективности существующих противомикробных средств.

Цель обзора — обобщить информацию о причинах и механизмах, лежащих в основе развития резистентности; ограничениях стандартных методов лечения; альтернативных методах лечения, способных бороться с развитием резистентности, их преимуществах и недостатках; а также о будущих задачах. Приведены сводные данные по альтернативным средствам антимикробной терапии, находящимся на разных этапах фармацевтической разработки.

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