Antimicrobial peptides from either microbial sources, or based on host defense peptides (HDPs) from higher organisms, show promising activity against human pathogens. Lantibiotics have been extensively engineered by either molecular biology approaches or chemistry and both natural and modified entities have been shown to have good efficacy in animal models of infection. Amongst HDPs either truncated peptides or non-peptide mimetic molecules show substantial promise both for their direct antibiotic action and also modulation of host functions. Members of both classes have reached clinical development for therapy of systemic infections and Clostridium difficile infection of the gastrointestinal tract.