Since the discovery of penicillin, β-lactam antibiotics have commonly been used to treat bacterial infections. Unfortunately, at the same time, pathogens can develop resistance to β-lactam antibiotics such as penicillins, cephalosporins, monobactams, and carbapenems by producing β-lactamases. Therefore, a combination of β-lactam antibiotics with β-lactamase inhibitors has been a promising approach to controlling β-lactam-resistant bacteria. The discovery of novel β-lactamase inhibitors (BLIs) is essential for effectively treating antibiotic-resistant bacterial infections. Therefore, this review discusses the development of innovative inhibitors meant to enhance the activity of β-lactam antibiotics. Specifically, this review describes the classification and characteristics of different classes of β-lactamases and the synergistic mechanisms of β-lactams and BLIs. In addition, we introduce potential sources of compounds for use as novel BLIs. This provides insights into overcoming current challenges in β-lactamase-producing bacteria and designing effective treatment options in combination with BLIs.

The excessive use of antibiotics has led to the emergence of multidrug-resistant (MDR) pathogens in clinical settings and food-producing animals, posing significant challenges to clinical management and food control. Over the past few decades, the discovery of antimicrobials has slowed down, leading to a lack of treatment options for clinical infectious diseases and foodborne illnesses. Given the increasing prevalence of antibiotic resistance and the limited availability of effective antibiotics, the discovery of novel antibiotic potentiators may prove useful for the treatment of bacterial infections. The application of antibiotics combined with antibiotic potentiators has demonstrated successful outcomes in bench-scale experiments and clinical settings. For instance, the use of efflux pump inhibitors (EPIs) in combination with antibiotics showed effective inhibition of MDR pathogens. Thus, this review aims to enable the possibility of using novel EPIs as potential adjuvants to effectively control MDR pathogens. Specifically, it provides a comprehensive summary of the advances in novel EPI discovery and the underlying mechanisms that restore antimicrobial activity. In addition, we also characterize plant-derived EPIs as novel potentiators. This review provides insights into current challenges and potential strategies for future advancements in fighting antibiotic resistance.

Biofilms remain a major challenge in the food industry due to the increased resistance of foodborne pathogens to antimicrobial agents and food processing stresses, leading to food contamination and significant health risks. Their resistance to preservation techniques, antimicrobial treatments, and processing conditions increases concerns regarding food safety. This review discusses recent developments in physical, chemical, and surface modification strategies to control and remove biofilms in food processing environments. Physical methods, such as thermal treatments, electric fields, and ultrasonic systems, have demonstrated their efficacy in disrupting biofilm structure and improving disinfection processes. Chemical treatments, including the use of sanitizers, disinfectants, acidulants, and enzymes, provide targeted approaches to degrade biofilm matrices and inhibit bacterial adhesion. Furthermore, surface modifications of food contact materials provide innovative solutions for preventing biofilm formation and enhancing food safety. These cutting-edge strategies not only improve food safety but also reduce contamination risk in food processing facilities. The review highlights the mechanisms, efficacy, and applicability of these techniques, emphasizing their potential to mitigate biofilm-associated risks and ensure food quality and safety.

The rapid emergence of antibiotic-resistant bacteria requires solutions that extend beyond conventional antibiotics. Bacteriophages (phages) provide targeted antibacterial action but face two key limitations: (1) their narrow natural host ranges and (2) the rapid emergence of evolved bacterial resistance. This review focuses specifically on evolved resistance and highlights two complementary strategies to overcome it by using phage-adaptive evolution and manipulating bacterial fitness trade-offs. Adaptive evolution accelerates phage/bacteria coevolution under host-mediated and environmental selective pressures such as receptor variability, bacterial resistance mutations, and nutrient limitations, resulting in phages with broader host targeting within resistant populations and enhanced lytic activity. Simultaneously, bacterial resistance to phages often leads to fitness costs, including restored antibiotic susceptibility or reduced virulence. These strategies support the rational design of phage/antibiotic combinations that suppress resistance and enhance therapeutic efficacy. In this review, we clarify the distinction between intrinsic host range limitations and evolved resistance, focusing on how adaptive strategies can specifically counter the latter. We discuss the underlying mechanisms, practical applications, and significance of this approach in clinical, agricultural, and environmental areas.

Bacteriophages (phages), the dominant prokaryotic viruses that specifically target bacteria in the human gut microbiome, play a crucial role in maintaining intestinal balance, regulating bacterial populations, and preserving microbial diversity within the gut microbiota. While prophages can enhance bacterial virulence and antibiotic resistance, potentially posing health risks, they also provide beneficial functions, including enhancing host fitness, promoting immune modulation, and contributing to ecosystem resilience, which supports intestinal homeostasis. Human gut microbiota is essential for various physiological functions, including digestion, vitamin synthesis, immune modulation, and protection against pathogens. Dysbiosis, or microbial imbalance, is associated with various disorders such as inflammatory bowel disease, obesity, diabetes, and mental health disorders. Consequently, prophages are important considerations for developing therapies to prevent intestinal diseases. Recently, there has been significant interest in prophage induction in the gut due to its functional impacts on microbial dynamics, gut health, and disease modulation. Prophage induction can be regulated by diet, antibiotics, metabolites, gut health, lifestyle, and intestinal environments. However, compared with lytic phages, prophages remain underexplored, leaving gaps in our understanding of their functions within the gut. Therefore, further research is needed to fully elucidate the complex interactions between phages, prophages, and the gut microbiota, and their effects on health and disease. This knowledge could inform the development of phage-based therapies and improve therapeutic strategies for gut health.

Health information literacy (HIL) is a significant concept that has gradually become known to the broader public in recent years. Although the definitions of HIL and health literacy seem to overlap, as an independent subconcept, HIL still shows a unique influence on improvements in people’s health and health education. Remarkable evidence indicates that online health information (OHI) can effectively enrich people’s knowledge and encourage patients to actively join the medical process, which is also accompanied by the emergence of various assessment tools. Although the current assessment tools, to a certain extent, can help people identify their shortcomings and improve their HIL, many studies have indicated that the deficiencies of the scales induce incomplete or unreal results of their HIL. In addition, continuing research has revealed an increasing number of influencing factors that have great effects on HIL and even regulate the different trends in doctor–patient relationships. Simultaneously, most of the uncensored OHI broadcasts have also affected the improvement in HIL in various ways. Thus, this review aims to summarize the assessment tools, influencing factors and current situations and challenges related to HIL. Further studies are required to provide more trusted and deeper references for the development of HIL.