4.5 Review

Novel treatment dynamics for biofilm-related infections

Journal

EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
Volume 19, Issue 11, Pages 1443-1456

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/14787210.2021.1917993

Keywords

Biofilm disease; recalcitrance; antibiofilm; coatings; biofilm dispersal; quorum quenching; phages; photodynamic therapy; persister; bioelectric effect

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There are multiple challenges in developing novel antibiofilm therapies, including the need for effective antibiofilm compound screening models, a lack of in vivo research, and the complexity of biofilm biology. The multifaceted nature of biofilms necessitates multi-targeted or combinatorial therapies to effectively combat biofilm-related infections.
Introduction: As a result of progress in medical care, a huge number of medical devices are used in the treatment of human diseases. In turn, biofilm-related infection has become a growing threat due to the tolerance of biofilms to antimicrobials, a problem magnified by the development of antimicrobial resistance worldwide. As a result, successful treatment of biofilm-disease using only antimicrobials is problematic. Areas covered: We summarize some alternative approaches to classic antimicrobials for the treatment of biofilm disease. This review is not intended to be exhaustive but to give a clinical picture of alternatives to antimicrobial agents to manage biofilm disease. We highlight those strategies that may be closer to application in clinical practice. Expert opinion: There are a number of outstanding challenges in the development of novel antibiofilm therapies. Screening for effective antibiofilm compounds requires models relevant to all clinical scenarios. Although in vitro research of anti-biofilm strategies has progressed significantly over the past decade, there is a lack of in vivo research. In addition, the complexity of biofilm biology makes it difficult to develop a compound that is likely to provide the single 'magic bullet'. The multifaceted nature of biofilms imposes the need for multi-targeted or combinatorial therapies.

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