Liposomes used in the delivery of various antimicrobials to biofilm-producing infections: a systematic review

Objective(s): Persistent clinical infections have driven extensive research to find effective solutions. Liposomes, known for their biocompatibility, versatility, targetability, and tunability, have emerged as a prominent drug delivery system. They enhance the delivery of contemporary antibiotics to resistant infections and facilitate the introduction of a wide range of novel antimicrobial agents.Materials and Methods: This review adopts a systematic and thematic approach to encompass all studies involving liposomal antimicrobials for biofilm-producing infections. Original papers were retrieved from NCBI/PubMed using MeSH terms ‘liposome’, ‘antimicrobial’, and ‘biofilm’. An inductive qualitative thematic analysis was then conducted to identify the main themes and sub-themes. Themes supporting the primary objective and fundamentals were included, while those covered in previous reviews were excluded.Results: Liposomes are an exceptional delivery system for treating clinical biofilm infections. They improve the delivery of contemporary hydrophobic antibiotics and enable the combinatorial introduction of natural and synthetic antimicrobials. Liposomes also serve as a suitable platform for controlled drug release, physicochemical modification, and surface functionalization with various biological ligands. Additionally, they allow for modifications that enhance adhesion to biotic and abiotic surfaces and support extended, prolonged drug release profiles with implants, scaffolds, and hydrogels.Conclusion: Given their ease of manipulation and modulation, liposomes are anticipated to remain a long-standing drug delivery platform in future research focused on treating persistent infections with antimicrobials.