Targeting Bacterial Biofilms in Antimicrobial Resistance: Emerging Therapeutic Approaches and Clinical Challenges

Bacterial biofilms are sessile microbial communities, and their inherent resistance to antimicrobials is the main cause of many persistent and chronic infections. Their complex and heterogeneous status provides conditions that may contribute to the emergence and dissemination of antimicrobial resistance. In this review, we examine the contribution of biofilms to antimicrobial resistance, and we provide an overview of emerging therapies designed to prevent, disrupt, or eliminate biofilm-associated infections. We also focus on studies published between 2021 and 2026, with earlier seminal studies considered where relevant to providing any necessary scientific context. Emphasis was placed on quorum sensing inhibitors, anti-virulence strategies, matrix-disrupting agents, bacteriophage-based approaches, and combination therapies with conventional antimicrobials. These approaches may produce promising antibiofilm effects in experimental and preclinical models, while their clinical value may be enhanced when combined with conventional antibiotics. However, challenges remain in translating these findings into clinical practice. Successful clinical implementation of antibiofilm therapies will depend on evidence of clinical benefit, together with reliable evaluation, manufacturing standards, and multidisciplinary care. Future research should focus on clinically relevant experimental models and well-designed studies to clarify the effectiveness of these approaches and identify the patient populations and clinical settings in which they may offer therapeutic benefit.