Abstract

REDEFINING THE BATTLE AGAINST MACROLIDE RESISTANCE: MECHANISMS, IMPLICATIONS, AND NEXT-GENERATION SOLUTIONS

Ketan Sonawane*, Gauri Soni and Prof. Gaurao Damre

ABSTRACT

Macrolide antibiotics have been essential in treating bacterial infections due to their broad- spectrum activity and established safety. However, rising macrolide resistance poses significant challenges to effective therapy. This review examines the mechanisms underlying resistance, including ribosomal target modifications, efflux pumps, and enzymatic inactivation, and their impact on clinical outcomes. Key findings highlight the global prevalence of resistance, with rates exceeding 30% in pathogens like Streptococcus pneumoniae and Mycoplasma pneumoniae, particularly in regions with weak antibiotic stewardship. Emerging strategies to combat resistance include the development of novel macrolide derivatives, combination therapies, and bacteriophage-based treatments, which show promise in overcoming resistance. The review underscores the need for robust surveillance systems, stricter antibiotic stewardship, and innovativeresearch to mitigate resistance and preserve the efficacy of macrolides. These efforts are crucial for safeguarding global public health against the evolving threat of antimicrobial resistance.

Keywords: Macrolide Resistance, Antimicrobial Stewardship, Public Health Impact, Combination Antibiotic Therapies, Multidrug Resistance.