Abstract
Antibiotics at subtherapeutic levels have been used in pig diets as antimicrobial growth promoters. However, concerns about antibiotic resistance have increased the demand for alternatives to these antimicrobial growth promoters. This review paper explores the mechanisms through which antimicrobial growth promoters and their alternatives exert their antimicrobial effects. Additionally, this systemic review also covers how modulation of intestinal microbiota by antimicrobial growth promoters or their alternatives affects intestinal health and, subsequently, growth of pigs. The mechanisms and effects of antimicrobial growth promoters and their alternatives on intestinal microbiota, intestinal health, and growth are diverse and inconsistent. Therefore, pig producers should carefully assess which alternative is the most effective for optimizing both profitability and the health status of pigs in their production system.