Antimicrobial resistance (AMR) has emerged as a major threat to public health globally. Accurate and rapid detection of resistance to antimicrobial drugs, and subsequent appropriate antimicrobial treatment, combined with antimicrobial stewardship, are essential for controlling the emergence and spread of AMR. This article reviews common antimicrobial susceptibility testing (AST) methods and relevant issues concerning the advantages and disadvantages of each method. Although accurate, classic technologies used in clinical microbiology to profile antimicrobial susceptibility are time-consuming and relatively expensive. As a result, physicians often prescribe empirical antimicrobial therapies and broad-spectrum antibiotics. Although recently developed AST systems have shown advantages over traditional methods in terms of testing speed and the potential for providing a deeper insight into resistance mechanisms, extensive validation is required to translate these methodologies to clinical practice. With a continuous increase in antimicrobial resistance, additional efforts are needed to develop innovative, rapid, accurate, and portable diagnostic tools for AST. The wide implementation of novel devices would enable the identification of the optimal treatment approaches and the surveillance of antibiotic resistance in health, agriculture, and the environment, allowing monitoring and better tackling the emergence of AMR.

The present study describes DPPH (2,2-diphenyl-1-picrylhydrazyl) radical scavenging activity and antimutagenic properties of the essential oil of myrtle (Myrtus communis L.). Plant samples were collected from the two distant localities (southernmost and northern point) of the Montenegro coastline. Chemical profiles of the two samples were evaluated by GC-MS. In both of the samples monoterpenes were found to be the predominant compounds. Among them a-pinene, linalool, 1,8-cineole, and myrtenyl acetate were the major compounds. Significant differences between the samples were found in the ranges of a-pinene (14.7%–35.9%) and myrtenyl acetate (5.4%–21.6%). Both oils exhibited moderate DPPH scavenging activity, with IC₅₀ values of 6.24 mg/mL and 5.99 mg/mL. The antimutagenic properties were assayed against spontaneous and t-BOOH-induced mutagenesis in Escherichia coli oxyR mutant IC202, a bacterial strain deficient in removing ROS. Reduction of the spontaneous mutagenesis in presence of myrtle EO was only slight, up to 13% at the highest concentration tested. When the oxidative mutagen was used, EO expressed higher reduction of mutagenesis, in a concentration dependent manner, with statistical significance for effect at the highest concentration tested (28%). Suppression of t-BOOH induced mutagenesis was correlated with the observed scavenging activity.

Background/Objectives: Antimicrobial resistance poses a major public health challenge. The World Health Organization has identified 15 priority pathogens that require prompt development of new antibiotics. This review systematically evaluates the antibacterial resistance of the most significant bacterial pathogens, currently available treatment options, as well as complementary approaches for the management of infections caused by the most challenging multidrug-resistant (MDR) bacteria. For carbapenem-resistant Gram-negative bacteria, treatment options include combinations of beta-lactam antibiotics and beta-lactamase inhibitors, a novel siderophore cephalosporin, known as cefiderocol, as well as older antibiotics like polymixins and tigecycline. Treatment options for Gram-positive bacteria are vancomycin, daptomycin, linezolid, etc. Although the development of new antibiotics has stagnated, various agents with antibacterial properties are currently in clinical and preclinical trials. Non-antibiotic strategies encompass antibiotic potentiators, bacteriophage therapy, antivirulence therapeutics, antimicrobial peptides, antibacterial nanomaterials, host-directed therapy, vaccines, antibodies, plant-based products, repurposed drugs, as well as their combinations, including those used alongside antibiotics. Significant challenges exist in developing new antimicrobials, particularly related to scientific and technical issues, along with policy and economic factors. Currently, most of the alternative options are not part of routine treatment protocols. Conclusions and Future Directions: There is an urgent need to expedite the development of new strategies for treating infections caused by MDR bacteria. This requires a multidisciplinary approach that involves collaboration across research, healthcare, and regulatory bodies. Suggested approaches are crucial for addressing this challenge and should be backed by rational antibiotic use, enhanced infection control practices, and improved surveillance systems for emerging pathogens.