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Biomaterial-based antimicrobial therapies for the treatment of bacterial infections

Abstract

The rise in antibiotic-resistant bacteria, including strains that are resistant to last-resort antibiotics, and the limited ability of antibiotics to eradicate biofilms have necessitated the development of alternative antibacterial therapeutics. Antibacterial biomaterials, such as polycationic polymers, and biomaterial-assisted delivery of non-antibiotic therapeutics, such as bacteriophages, antimicrobial peptides and antimicrobial enzymes, have improved our ability to treat antibiotic-resistant and recurring infections. Biomaterials not only allow targeted delivery of multiple agents but also sustained release at the infection site, thereby reducing potential systemic adverse effects. In this Review, we discuss biomaterial-based non-antibiotic antibacterial therapies for the treatment of community-acquired and hospital-acquired infectious diseases, with a focus on in vivo results. We highlight the translational potential of different biomaterial-based strategies and provide a perspective on the challenges associated with their clinical translation. Finally, we discuss the future scope of biomaterial-assisted antibacterial therapies.

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Fig. 1: Biomaterial-based antibacterial therapies.
Fig. 2: Proposed mechanism of action of different non-antibiotic antibacterial agents.
Fig. 3: Nanoparticle-based and microparticle-based antibacterial therapies.
Fig. 4: Hydrogel-based antibacterial therapies.

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Acknowledgements

The authors acknowledge support from the Cystic Fibrosis Foundation (CFF GARCIA17G0) and the National Institutes of Health (R01 AR062920).

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P.P.K. and A.J.G. conceived the idea of the Review, developed the outline, contributed to the literature search, writing, and creation of figures and tables. M.R. contributed to the literature search and writing of the section on bacteriophage-based biomaterials, as well as the creation of figures and tables. All authors contributed to the discussion, review and editing of the entire article content.

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Correspondence to Andrés J. García.

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A.J.G. is an inventor in a patent application on the lysostaphin-delivering hydrogel filed by the Georgia Tech Research Corporation (no. 16/191,685, filed on 15 November 2018). The authors declare no other competing interests.

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Kalelkar, P.P., Riddick, M. & García, A.J. Biomaterial-based antimicrobial therapies for the treatment of bacterial infections. Nat Rev Mater (2021). https://doi.org/10.1038/s41578-021-00362-4

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