Non-Antibiotic Anti-Virulence Strategies Against Multidrug-Resistant Bacterial Pathogens: A Review

Abstract

The increasing prevalence of bacteria resistant to multiple antimicrobial drugs has become a major global health concern, creating an urgent need for alternative approaches to infection management. This review was conducted to evaluate the potential of non-antibiotic agents as anti-virulence therapies that target bacterial pathogenic mechanisms without directly killing bacteria. Published studies on natural compounds, probiotics, bacteriophages, antimicrobial peptides, nanoparticles, and repurposed drugs were examined. The findings indicate that these agents can reduce bacterial pathogenicity by inhibiting adhesion, neutralizing toxins, disrupting cell-to-cell communication, preventing biofilm formation, and modulating host immune responses. Advances in screening technologies and computerassisted drug design have further supported the identification of agents targeting specific virulence pathways. These approaches may reduce the development of antimicrobial resistance while preserving beneficial microorganisms. In conclusion, non-antibiotic anti-virulence therapies represent a promising strategy for controlling resistant bacterial infections and may improve future treatment outcomes when used alone or alongside conventional antimicrobial agents.