“…Furthermore, antibiotic therapy is long-lasting, and to achieve effective therapeutic drug concentration at the site of infection, a high parenteral dose of antibiotic is needed, which can lead to systemic toxicity . New approaches have been sought after, in the form of antimicrobial surfaces, that can be divided into structured surfaces, permanent antimicrobial surfaces, and elution systems. , Structures such as nanoparticle- and nanotube-modified surfaces, , and engineered metal topographies such as alterations in charge, hydrophobicity, roughness, and porosity ,, have been studied. Permanent antimicrobial surfaces, that contain permanently bonded agents that generate antimicrobial surfaces and prevent long-term bacterial adhesion , have also been created. − To further improve the antimicrobial effect of implants, studies veered into the usage of drugs in their composition, via the creation of elution systems, that actively release antimicrobials to inhibit bacterial adhesion and/or promote bacterial cell death in both the implant and adjacent tissues .…”