Antimicrobial Peptides: the Achilles' Heel of Antibiotic Resistance?

Probiotics Antimicrob Proteins. 2019 Jun;11(2):370-381. doi: 10.1007/s12602-018-9465-0.


Antibiotic resistance is an imminent threat to the effective treatment of bacterial infections, and alternative antibiotic strategies are urgently required. The golden epoch of antibiotics is coming to an end, and the development of new therapeutic agents to combat bacterial infections should be prioritized. This article will review the potential of antimicrobial peptides (AMPs) to combat the threat of antimicrobial resistance. The modern-day antimicrobial resistance dilemma is briefly discussed followed by a review of the potential of AMPs to be used alone or in combination with current antibiotics in order to enhance antibacterial properties of antibiotics while also potentially combatting resistance. This article reiterates that many AMPs exhibit direct microbial killing activity and also play an integral role in the innate immune system. These properties make AMPs attractive alternative antimicrobial agents. Furthermore, AMPs are promising candidates to be used as adjuvants in combination with current antibiotics in order to combat antibiotic resistance. Combinations of AMPs and antibiotics are less likely to develop resistance or transmit cross-resistance. The further identification and therapeutic development of AMPs and antibiotic-AMP combinations are strongly recommended.

Keywords: Adjuvant therapy; Antibiotic resistance; Antimicrobial peptides; Innate immunity; Synergism.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Antimicrobial Cationic Peptides / pharmacology*
  • Antimicrobial Cationic Peptides / therapeutic use
  • Bacterial Infections / drug therapy
  • Drug Resistance, Microbial / drug effects*
  • Humans
  • Immunity, Innate / drug effects
  • Immunologic Factors / pharmacology


  • Anti-Bacterial Agents
  • Antimicrobial Cationic Peptides
  • Immunologic Factors