Designing antimicrobial peptides: form follows function

Natural antimicrobial peptides defend host organisms against microbes, but most have modest direct antibiotic activity. This article reviews the latest computer-assisted design strategies to develop enhanced peptide variants, and examines emerging data from clinical trials. These broad-spectrum peptides could lead to the development of next-generation antibiotics. Multidrug-resistant bacteria are a severe threat to public health. Conventional antibiotics are becoming increasingly ineffective as a result of resistance, and it is imperative to find new antibacterial strategies. Natural antimicrobials, known as host defence peptides or antimicrobial peptides, defend host organisms against microbes but most have modest direct antibiotic activity. Enhanced variants have been developed using straightforward design and optimization strategies and are being tested clinically. Here, we describe advanced computer-assisted design strategies that address the difficult problem of relating primary sequence to peptide structure, and are delivering more potent, cost-effective, broad-spectrum peptides as potential next-generation antibiotics.