Exosome based nanocarriers enabling effective treatment of antimicrobial resistant infections through improved delivery and clinical potential

Exosome-mediated drug delivery recently emerged as a viable approach for enhancing the therapeutic effectiveness of antimicrobial medicines in combating multidrug-resistant (MDR) pathogenic bacteria. Due to their inherent biocompatibility, biomimetic membrane structure, and effective cargo transport abilities, exosomes confront numerous drawbacks linked to traditional antimicrobial delivery systems, such as suboptimal drug stability, restricted biofilm infiltration, insufficient intracellular delivery, and unintended toxicity. This analysis offers an extensive summary of the latest developments in exosome-facilitated antimicrobial delivery, emphasising the conveyance of antibiotics, antimicrobial peptides, nucleic acids, and hybrid nanotherapeutics. Processes through which exosomes increase antimicrobial effectiveness, such as improved biofilm infiltration, intracellular localisation, immune system modulation, and precise cargo delivery, are comprehensively discussed. Recent advancements in exosome manipulation, cargo-loading methodologies, hybrid exosome-centric systems, and pathogen-specific delivery techniques are critically reviewed. Furthermore, this review discusses critical translational obstacles including scalable production, cargo-loading efficacy, quality assurance, storage durability, regulatory harmonisation, and clinical application. The evidence gathered highlights the potential of exosome-based delivery systems as novel biomimetic nanocarriers in the battle against antimicrobial resistance. It also highlights the technological and regulatory developments required for their successful clinical application.