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Emerging Multimodal Strategies for Bacterial Biofilm Eradication: A Comprehensive Review

Hindieh P, Yaghi J, Assaf JC, Chokr A, Atoui A, Tzenios N, Louka N, Khoury AE

Microorganisms, 2025

24 citations

Abstract

Bacterial biofilms pose significant challenges in clinical, industrial, and environmental settings due to their inherent resistance to antimicrobial agents and host immune responses. Encased within a self-produced extracellular polymeric substance (EPS) matrix, these structured microbial communities demonstrate exceptional resilience, resisting conventional antimicrobial treatments and adapting to, as well as recovering from, environmental and therapeutic stresses, necessitating the development of novel anti-biofilm strategies. This review provides a comprehensive synthesis of biofilm formation, resistance mechanisms, and current and emerging approaches for controlling biofilms, with a primary focus on advancements made over the last decade. Chemical, physical, and biological strategies, including enzymatic degradation, natural compounds, chelating agents, nanoparticles, photodynamic therapy, and probiotics, have demonstrated promising antibiofilm activity. Additionally, combination therapies and targeted drug delivery systems have emerged as viable solutions to enhance the eradication of biofilms. Despite these advancements, challenges such as cytotoxicity, bacterial adaptation, and clinical applicability remain. Addressing these hurdles requires interdisciplinary research to refine existing strategies and develop innovative solutions for effective biofilm management.

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