With antibiotic resistance becoming an increasing problem in medical treatment, the search is on for new antibiotics, new sources for those antibiotics and new mechanisms. For thousands of years people have used products found in nature for their medicinal properties. A return to nature may be the next area in which we find antibiotics.

Smaller pharmaceutical companies are still pursuing research and manufacturing, and they are submitting regulatory documents for new antibiotics to the FDA for their approval. But perhaps more importantly and more promising is the work being done to look for novel mechanisms and to explore different areas in the search.

One of the first steps is looking for what causes antibiotic resistance. In addition to the generally accepted reasons for antibiotic resistance (inappropriate use, overuse, use in animal feed, extended treatment times), researchers have begun to look even further.

Genetic changes

Scientists from Princeton University discovered that similar strains of pathogenic bacteria (E. coli) have the ability to mutate using different genetic changes to develop antibiotic resistance in more ways than previously thought. The research resulted in a new way to identify genetic changes in disease-causing bacteria that are responsible for antibiotic resistance.

The genome-wide association study found single-letter changes in the DNA of Streptococcus pneumoniae that enabled it to evade antibiotic treatment. Work still needs to be done to fine-tune the technique, but the hope is that within the next decade it will be available in clinics to help decide on the most effective treatments for diseases such as pneumonia and meningitis.

Antibacterial supergel

Scientists at Queens University in Belfast have made a major breakthrough in treating and killing hospital "superbugs" including Ps. aeruginosa, E. coli, and staphylococcus.

They developed a novel treatment, an antibacterial gel that uses natural proteins to give the gel the ability to break down the thick jelly-like coatings (known as biofilms) that cover bacteria making them highly resistant to current therapies. In breaking down the bacteria's biofilm, the treatment leaves healthy cells unaffected.

Trojan horse mechanism

One new antibiotic on the horizon is an injectable cephalosporin, which has a novel mechanism of action to enter bacterial cells that researchers call the "Trojan horse mechanism." The antibiotic, S-649266, is showing potential for difficult-to-treat infections caused by a wide variety of gram-negative pathogens.

In lab and animal studies, it has shown more robust antibacterial activity than established antibiotics — even other cephalosporins against multidrug-resistant Pseudomonas, Acinetobacter and carbapenem-resistant Enterobacteriaceae.

Bacteria in honeybees

Researchers in Sweden have discovered that a group of lactic acid bacteria found in the stomachs of honeybees has antimicrobial properties including the ability to fight MRSA and other human bacteria in the lab. They are investigating this phenomenon using fresh honey that contains the live bacteria, as opposed to the kind of honey found commercially in stores, as an alternative/addition to antibiotics.

As antibiotic resistance continues to escalate and the need to find new antibiotics becomes more urgent, researchers are looking back at nature, soil, insects and plants, where many current antibiotics, like penicillin and streptomycin began.