Targeting multidrug-resistant pneumonia: The potential of combined antibiotic therapies and non-antimicrobial approaches

As antibiotics are widely used, multidrug-resistant pneumonia has emerged as a grave global health challenge. Multidrug-resistant pneumonia is mainly caused by Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii, among others. Its resistance mechanisms involve various biological processes such as mutations in efflux pump genes, the development of bacterial biofilms, and the secretion of inactivating enzymes. Given the limited effectiveness of traditional single-agent antimicrobial therapy in treating multidrug-resistant pneumonia, the medical community has now shifted towards combination therapy strategies, including precision medication based on drug susceptibility testing, combinations of antibiotics with different mechanisms of action, and phage therapy. Despite the current challenges, such as drug toxicity and the determination of optimal combination regimens, combination therapy offers new hope for overcoming multidrug-resistant pneumonia. This article reviews the current status of multidrug-resistant pneumonia, its resistance mechanisms, and the potential of combination therapy.