Antimicrobial therapies are one of the great scientific achievements of the 20th century. For centuries, bacterial infections were deadly, with infamous diseases such as tuberculosis and the bubonic plague seemingly unstoppable. In the 1940s, scientists turned the table on these invisible killers with the discovery of penicillin, the first antibiotic. Viral, fungal, and parasitic infections are also now treatable with small molecule antimicrobial therapies obtained from a local pharmacy.
Although it may seem as if we’ve turned our back on the days in which minor infections were deadly, antimicrobial resistance has become a global health threat. This phenomenon occurs when bacteria, viruses, fungi, and parasites adapt over time and no longer respond to antimicrobial therapies, which increases the risk of disease spread, severe illness, and death. Bacteria can form protective physical barriers or biofilms against antibiotic therapies, a process known as structural antimicrobial resistance, which is often associated with relapse following treatment and is particularly prevalent in urinary tract infection (UTI) patients.
One possible solution to antimicrobial resistance is combining existing antimicrobial therapies with adjuvants. For example, co-amoxiclav, a combination of amoxicillin and clavulanic acid, is widely used today; clavulanic acid inhibits beta-lactamase, an enzyme produced by amoxicillin-resistant bacteria. Similarly, could we combine antibiotics with an adjuvant that breaks down biofilms to specifically address structural antimicrobial resistance?