Bacterial infections remain one of the leading causes of death worldwide, and the options for treating such infections are decreasing, due to the rise of antibiotic-resistant bacteria. In fact, the continuing rise of antibiotic resistance is such a major global health concern that the World Health Organization has warned that we may enter a "postantibiotic era" within this century, and they propose that urgent actions should be taken. Nevertheless, since the pharmaceutical industry has not produced a new class of antibiotics for more than a decade, researchers are taking several approaches towards developing new classes of bacterial anti-infectives, including focusing on new targets and processes, such as bacterial biofilm formation, that is related to approximately 65% of human infections. Moreover, significant advances have been made in the development of therapies aimed to attenuate the damage produced by bacterial infections by the downregulation of bacterial virulence instead of directly targeting bacterial growth, in contrast to conventional antibiotics. Furthermore, other active research areas are the utilization of molecules produced by commensal and mutualist bacteria as antibacterials to inhibit the growth of pathogenic species, and to boost the immune system in order to promote the elimination of infections. Other alternative treatments are focused on inhibiting bacterial multidrug resistance mechanisms, such as the active efflux of antibiotics by multidrug efflux pumps. In this chapter, we discuss the recent advances in the development of novel bacterial anti-infectives, analyzing their anti-infective mechanisms, their activity in vitro and in vivo, and the advances toward their clinical implementation.
Keywords: Bacterial anti-infectives, biofilm inhibitors, host defense peptides, silver nanoparticles, gallium, quorum sensing inhibitors, quorum quenching, probiotics, prebiotics, eubiotics, bacteriocins, vaccines, immunomodulation.