Emerging Antibacterial Strategies with Application of Targeting Drug Delivery System and Combined Treatment

Abstract

At present, some bacteria have developed significant resistance to almost all available antibiotics. One of the reasons that cannot be ignored is long-term exposure of bacteria to the sub-minimum inhibitory concentration (MIC) of antibiotics. Therefore, it is necessary to develop a targeted antibiotic delivery system to improve drug delivery behavior, in order to delay the generation of bacterial drug resistance. In recent years, with the continuous development of nanotechnology, various types of nanocarriers that respond to the infection microenvironment, targeting specific bacterial targets, and targeting infected cells, and so on, are gradually being used in the delivery of antibacterial agents to increase the concentration of drugs at the site of infection and reduce the side effects of drugs in normal tissues. Here, this article describes in detail the latest research progress on nanocarriers for antimicrobial, and commonly used targeted antimicrobial strategies. The advantages of the combination of nanotechnology and targeting strategies in combating bacterial infections are highlighted in this review, and the upcoming opportunities and remaining challenges in this field are rationally prospected.

Advances in Nanostructures for Antimicrobial Therapy

“…Besides the penetration of the bacterial cell wall and the destruction permeability of the cell membrane and the structure and function of cell macromolecules due to production of reactive oxygen species (ROS), NPs can kill the bacteria and overcome multi-drug resistance because they are able to affect several targets in bacterial cells and exhibit synergistic effect with conventional antibiotics, resulting in improved antibacterial effectiveness [ 79 , 90 ]. Recent progress in NCs targeting specific bacterial targets and targeting infected cells, which respond to the infection microenvironment and are able to ensure sustained release of antibacterial drugs and their increased levels the site of infection along with minimizing adverse side effects of drugs in non-infected tissues were summarized by Zhang et al [ 91 ]…”

A protein-based self-healing hydrogel for prolonged antimicrobial drug delivery with synergistic activity

“…1 Regarding antibiotics, the main reasons behind bacterial resistance are excessive use and misuse. 2 Another factor is when the antibiotic concentration at the site of action is below the minimum level (MIC) needed to inhibit the microbes effectively. When the drug concentration remains consistently lower than the MIC at the infection site, certain bacteria can develop resistance to the antibiotic.…”

A Polysaccharide-Based pH-Sensitive Hybrid Hydrogel as a Sustained Release Matrix for Antimicrobial Drugs

“…If the drug concentration reached below the MIC at the site of action for a long time, some bacteria may become antibacterial-resistant. 2 Sometimes, low-dose antibiotics can considerably influence biofilm formation, which increases the MIC level of the antibiotics. 2 In general, highdose or powerful antibiotics are administered to chronically infected patients.…”

“…2 Sometimes, low-dose antibiotics can considerably influence biofilm formation, which increases the MIC level of the antibiotics. 2 In general, highdose or powerful antibiotics are administered to chronically infected patients. Nevertheless, drug delivery strategies can improve patient health by increasing the concentration of a drug at its target site; releasing the drug sustainably; minimizing unwanted drug accumulation; and improving poor bioavailability, dose frequency, and patient compliance.…”

“…Another reason is an antibiotic’s subminimum inhibitory concentration (MIC) in the site of action. If the drug concentration reached below the MIC at the site of action for a long time, some bacteria may become antibacterial-resistant . Sometimes, low-dose antibiotics can considerably influence biofilm formation, which increases the MIC level of the antibiotics .…”