Combating multi-drug resistance with silver nanoparticles: A systematic review

Multi-drug resistance (MDR) among pathogens is a growing public health crisis, necessitating innovative antimicrobial strategies. Silver nanoparticles (AgNPs) offer a promising solution due to their unique physicochemical properties and broad-spectrum antimicrobial activity. AgNPs disrupt bacterial cell membranes, generate reactive oxygen species (ROS), and interfere with DNA and protein synthesis, making them effective against a variety of MDR pathogens. Additionally, they exhibit synergistic effects with conventional antibiotics, enhancing treatment efficacy. Optimizing the antimicrobial properties of AgNPs involves diverse synthesis methods, including chemical and biological approaches that influence their size, shape, and surface characteristics. These factors critically determine their effectiveness against MDR bacteria such as methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli, Pseudomonas aeruginosa, and fungal pathogens like Candida albicans. AgNPs also show promise against viruses, offering a versatile antimicrobial approach. Regulatory and ethical considerations are essential for the safe clinical application of AgNPs. Clinical trials have demonstrated the efficacy of AgNPs in treating MDR infections which enhances their antimicrobial capabilities, and overcome resistance. This review explores the growing potential of AgNPs as alternative antimicrobial agents to combat MDR pathogens. It systematically discusses their synthesis methods, antimicrobial mechanisms, efficacy, toxicity profiles, recent advancements, and translational challenges, including insights from clinical trials.