The increasing rate of antibiotic resistance constitutes a global health crisis. Antimicrobial peptides (AMPs) have the property to selectively kill bacteria regardless of resistance to traditional antibiotics. However, several challenges (e.g., reduced activity in the presence of serum and lack of efficacy in vivo) to clinical development need to be overcome. In the last two decades, we have addressed many of those challenges by engineering cationic AMPs de novo for optimization under test conditions that typically inhibit the activities of natural AMPs, including systemic efficacy. We reviewed some of the most promising data of the last two decades in the context of the advancement of the field of helical AMPs toward clinical development.
Keywords: ESKAPE pathogens; antibiotic resistance; antibiotics; antimicrobial peptides; cationic amphipathic peptides; colistin; gene-encoded antimicrobial peptides; helical antimicrobial peptides; host defense peptides; multidrug-resistant bacteria; peptide antibiotics; polymyxins; synergy.