ABSTRACT
Multidrug resistance is increasing globally because of greater access to antibiotics in developing countries and therefore there is the need for an international search for novel drugs. Resistant microbes are more difficult to treat, and require alternative medications or higher doses of antimicrobials. These approaches may be more expensive, more toxic or both. There is a paradigm shift from mono-drug therapy to multidrug combination regimens. Phytochemicals can be a potential alternative antimicrobial to combat superbugs. They have the ability to bind to protein domains leading to modification or inhibition of protein-protein interactions, leading to the death of microorganisms by affecting key events in the pathogenic process and reducing their ability to develop resistance. It has been observed that some phytochemicals exert a synergistic effect in combination with antibiotics. The phytochemicals are found to be effective modulators of host-related cellular processes viz. immune response, mitosis, apoptosis and signal transduction.
Based on specific isobolograms, the combination of phytochemicals with synthetic antibiotic drugs can be additive, over-additive or potentiated effects (synergistic) with zero or antagonistic effects. Additionally, the main limitations of synthetic antibiotics are low bioavailability and solubility, and instability in the gastrointestinal tract which reduces the potential health benefits. The failure of synthetic drugs in the treatment of multi-drug-resistant bacteria further emphasizes the importance of the proposed chapter to focus in this direction.
Nanoparticle-based therapeutic approaches have great clinical potential but we need to confirm their safety and efficacy. Therefore, the main focus will be on the role of natural products as antimicrobial agents and their combinations with different nanoparticles in combating multidrug resistance caused by superbugs.
