The growing bacterial resistance represents one of the greatest threats to modern medicine and significantly compromises the success of bacterial infections treatment. Although several new antibacterial drugs have been approved since 2010, most represent optimization of already established chemical classes or combinations of existing antibacterial agents with inhibitors of resistance mechanisms. Completely new mechanisms of action remain rare, and the development of new agents lags behind the rate of spread of bacterial resistance. Research is increasingly focused on alternative therapeutic approaches or methods of drug discovery, such as artificial intelligence in drug discovery, bacteriophage therapy, antivirulence drugs, monoclonal antibodies, antiadhesive therapy, inhibition of bacterial efflux pumps, microbiome-targeted therapy, nanotechnology and combination therapies. The purpose of this review article is to present the key development directions of modern antibacterial agents and approaches, assess their advantages and limitations, and shed light on future trends that will significantly impact the future treatment of bacterial infections.
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