Antimicrobial Synergies in Biofilm Infections
Summary
The formation of bacterial biofilms on tissues and medical devices presents a formidable challenge to antimicrobial therapy. These structured communities embed cells in an extracellular matrix, limiting antibiotic penetration and facilitating resistance. Recent research has focused on exploiting synergistic interactions between agents to enhance biofilm disruption, reduce effective doses and mitigate resistance development. Combinations of antibiotics with complementary mechanisms—such as cell‐wall synthesis inhibitors paired with membrane‐disrupting agents—have shown improved inhibitory activity against both Gram‐positive and Gram‐negative biofilms in vitro and in vivo. Adjunctive strategies, including sequential administration and incorporation of antibiofilm adjuvants, further potentiate efficacy. Such approaches hold promise for managing chronic and device‐associated infections by targeting multiple biofilm‐specific phenotypes, reducing treatment duration and improving patient outcomes on a global scale.
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Antimicrobial Synergies in Biofilm Infections publication trend
The graph below shows the total number of articles in antimicrobial synergies in biofilm infections across all publications each year (not limited to Nature Index journals).
Technical terms
Biofilm: A structured microbial community embedded in a self‐produced polymeric matrix attached to surfaces, which confers enhanced tolerance to antimicrobials.
Synergy: An interaction between two or more antimicrobial agents that produces a combined effect greater than the sum of their individual effects.
Fractional Inhibitory Concentration Index (FICI): A quantitative measure of drug interaction determined by comparing the minimum inhibitory concentrations of each agent alone and in combination, where values ≤0.5 indicate synergy.
Minimal Biofilm Eradication Concentration (MBEC): The lowest concentration of an antimicrobial required to eradicate a mature biofilm in vitro.
References
- In Vitro Antibiofilm Activity of Fosfomycin Alone and in Combination with Other Antibiotics against Multidrug-Resistant and Extensively Drug-Resistant Pseudomonas aeruginosa. Pharmaceuticals (2024).
- Antibiotics with antibiofilm activity – rifampicin and beyond. Frontiers in Microbiology (2024).
- The Efficacy of Colistin Combined with Amikacin or Levofloxacin against Pseudomonas aeruginosa Biofilm Infection. Microbiology Spectrum (2022).
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