
doi: 10.1007/15695_2017_4
Biofilms are microbial communities with enhanced interbacterial communication and cooperation. A good knowledge of anti-biofilm options is essential to ensuring correct management and treatment of biofilm-driven infections, with two main interest areas, namely prevention of biofilm formation and eradication of mature biofilm. Wounds can become infected with a wide array of germs, and among frequently encountered pathogens are Staphylococcus aureus and Pseudomonas aeruginosa, either separately or in microbial consortia. Depending on the type of wound, different techniques can be used to prevent, reduce, or eradicate biofilms, including mechanical options, surgical wound care, use of specific absorbent dressings, antiseptic soaks, or administering antibiotics either systemically or locally. Antimicrobial associations may be useful alternatives to single-agent therapy for biofilms, but they should be thoughtfully chosen, to ensure synergy. When dealing with S. aureus biofilms, fifth-generation cephalosporins, lipoglycopeptides, lipopeptides, oxazolidinones, or glycylcyclines may display important anti-biofilm effect, and the same is true for the association of rifampin or gentamicin to other active anti-S. aureus agents. For P. aeruginosa biofilm-driven infections, options include fluoroquinolones such as levofloxacin and ciprofloxacin, potentially associated with colistin. Bacteriophages are gradually gaining more important roles in the armamentarium of anti-biofilm agents, and so are engineered peptides or natural products extracted from plants or bacteria.
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