Microbial Bioactives
Microbial Bioactives | Online ISSN 2209-2161
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Volume 9 Number 1 2026
REVIEWS (Open Access)
Natural Bioactive Compounds and Drug Repurposing Strategies for Respiratory Diseases and Antimicrobial Resistance: A Systematic Review and Meta-Analysis
Md. Mahmuduzzaman Mian 1*, Sheikh Salehin Muhammad Faisal 2, Md. Ibrahim 2
Microbial Bioactives 9 (1) 1-8 https://doi.org/10.25163/microbbioacts.9110624
Submitted: 14 January 2026 Revised: 02 March 2026 Accepted: 10 March 2026 Published: 12 March 2026
Abstract
Respiratory diseases remain a leading cause of global morbidity and mortality, compounded by the accelerating crisis of antimicrobial resistance (AMR) that undermines the effectiveness of existing therapies. Conventional drug development pipelines have struggled to deliver sufficient new antimicrobials, prompting renewed interest in alternative therapeutic strategies. This systematic review and meta-analysis synthesizes evidence on bioactive compounds derived from natural sources—particularly molluscs, Andean berries, plant-associated microorganisms, and animal venoms—alongside repurposed pharmaceutical agents, with relevance to respiratory diseases, inflammation, and resistant infections. Following PRISMA-guided methodologies, eligible experimental, preclinical, and clinical studies were systematically identified, screened, and analyzed to evaluate pharmacological mechanisms and therapeutic outcomes. The reviewed evidence highlights that molluscan-derived antimicrobial peptides, hemocyanins, and secondary metabolites exhibit anti-inflammatory, immunomodulatory, antimicrobial, and anticancer activities pertinent to respiratory pathology. Plant-derived anthocyanins from Andean berries demonstrate antioxidant, anti-biofilm, and antimicrobial effects, while microbial endophytes, particularly Burkholderia species, produce specialized metabolites active against multidrug-resistant Gram-negative pathogens. Complementary to natural product discovery, drug repurposing strategies reveal that approved agents such as ciclopirox and pentamidine can sensitize resistant bacteria and enhance host-directed therapeutic responses. Meta-analytical synthesis indicates consistent trends toward reduced inflammatory markers, inhibition of pathogenic growth, and improved therapeutic efficacy across diverse model systems, although heterogeneity in study design and outcome measures persists. Collectively, the findings underscore the therapeutic potential of integrating natural bioactive compounds with repurposed drugs to address respiratory disease and AMR. This work provides a consolidated evidence base to guide future translational research and rational drug development.
Keywords: Respiratory diseases; antimicrobial resistance; natural bioactive compounds; molluscs; Andean berries; drug repurposing; systematic review; meta-analysis
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