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KMID : 1146920230530050627
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Journal of Pharmaceutical Investigation
2023 Volume.53 No. 5 p.627 ~ p.641
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Antimicrobial strategies for topical biofilm-based wound infections: past, present, and future
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Raj Kumar Thapa
Kim Jong-Oh
Kim Jeong-Hwan
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Abstract
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Background : Chronic wound infections are a serious global health concern affecting millions of people. One of the major challenges in treating biofilm-based wound infections is the presence of an extracellular polymeric substance (EPS) that limits the penetration of antimicrobial agents.
Area covered : This review focuses on conventional, current, and prospective anti-biofilm therapies for treating topical biofilm-based wound infections. Conventional strategies involving wound debridement, topical antibiotics, pH modulation, and surfactants have limited efficacy owing to the regrowth of bacteria, development of bacterial resistance, and difficulty in pH modulation. Improvements in anti-biofilm strategies involve current treatment modalities such as antimicrobial peptides, photodynamic substances, bacteriophages, quorum sensing inhibitors, nanoparticles, and hybrid hydrogels. Such strategies exhibit potent anti-biofilm effects upon topical application by targeting multiple mechanisms. However, the prospects of microbial resistance are still prevalent. Therefore, prospective strategies, such as Natural Deep Eutectic Solvents (NADES) and Clustered Regularly Interspaced Short Palindromic Repeats interfering system (CRISPRi), are required for effective anti-biofilm therapy of infected wounds.
Expert opinion : Strategies that completely eradicate biofilm-forming bacteria at wound sites can promote infection control and subsequent wound healing. Further developments in prospective strategies for topical anti-biofilm therapy for infected wounds are warranted. Our review provides valuable insights into the challenges and advancements in the treatment of biofilm-based wound infections, and highlights the need for ongoing research in this area.
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KEYWORD
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Antimicrobial, Biofilm, Treatment, Wound infection
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