Targeting biofilm-driven antibiotic resistance: emerging mechanisms and next-generation therapeutic interventions

Biofilm mediated antimicrobial resistance (AMR) has become a critical global health and economic challenge, affecting both community and healthcare settings. Microbial Biofilms significantly enhance the antibiotic tolerance and cause the persistent and device-associated infections via limited drug penetration, degradation of antibiotics, and assist horizontal gene transfer. Biofilm-mediated antimicrobial resistance remains a major obstacle to treating infectious diseases today. Biofilms can boost antibiotic tolerance by up to 1,000 times and lead to chronic, persistent, and device-associated infections. The lack of FDA-approved anti-biofilm drugs highlights the urgent need for new therapeutic strategies and mechanistic insights. Redefining the treatment landscape and improving outcomes for resistant infections could be achieved through a multi-platform therapeutic approach. This review summarizes recent developments in our knowledge of how biofilms contribute to antibiotic resistance and highlights new therapeutic strategies, such as nanotechnology, antimicrobial peptides, bacteriophage-derived enzymes, quorum-sensing inhibitors, CRISPR-based tools, microbiome engineering, and AI-driven drug discovery.