Biofilm formation is a key virulence factor for a wide range of microorganisms that cause chronic infections. The multifactorial nature of biofilm development and drug tolerance imposes great challenges for the use of conventional antimicrobials and indicates the need for multi-targeted or combinatorial therapies. In this Review, we focus on current therapeutic strategies and those under development that target vital structural and functional traits of microbial biofilms and drug tolerance mechanisms, including the extracellular matrix and dormant cells. We emphasize strategies that are supported by in vivo or ex vivo studies, highlight emerging biofilm-targeting technologies and provide a rationale for multi-targeted therapies aimed at disrupting the complex biofilm microenvironment.

生物膜的形成是引起慢性感染的多种微生物的关键毒力因素。生物膜形成和耐药性的多因素性质给传统抗菌药物的使用带来了巨大的挑战，并表明需要多靶点或组合疗法。在这篇综述中，我们重点关注当前的治疗策略和正在开发的治疗策略，这些策略针对微生物生物膜的重要结构和功能特征以及药物耐受机制，包括细胞外基质和休眠细胞。我们强调体内或离体研究支持的策略，强调新兴的生物膜靶向技术，并为旨在破坏复杂生物膜微环境的多靶向治疗提供理论依据。