To tackle the emerging antibiotic resistance crisis, novel antimicrobial approaches are urgently needed. Bacterial communities (biofilms) are a particular concern in this context. Biofilms are responsible for most human infections and are inherently less susceptible to antibiotic treatments. Biofilms have been linked with several challenging chronic diseases, including implant-associated osteomyelitis and chronic wounds. The specific local environments present in the infected tissues further contribute to the rise in antibiotic resistance by limiting the efficacy of systemic antibiotic therapies and reducing drug concentrations at the infection site, which can lead to reoccurring infections. To overcome the shortcomings of systemic drug delivery, encapsulation within polymeric carriers has been shown to enhance antimicrobial efficacy, permeation and retention at the infection site. In this Review, we present an overview of current strategies for antimicrobial encapsulation within polymeric carriers, comparing challenges and solutions on a tissue-by-tissue basis. We compare challenges and proposed drug delivery solutions from the perspective of the local environments for biofilms found in oral, wound, gastric, urinary tract, bone, pulmonary, vaginal, ocular and middle/inner ear tissues. We will also discuss future challenges and barriers to clinical translation for these therapeutics. The following Review demonstrates there is a significant imbalance between the research focus being placed on different tissue types, with some targets (oral and wound biofims) being extensively more studied than others (vaginal and otitis media biofilms and endocarditis). Furthermore, the importance of the local tissue environment when selecting target therapies is demonstrated, with some materials being optimal choices for certain sites of bacterial infection, while having limited applicability in others.

为了应对新出现的抗生素耐药性危机，迫切需要新的抗菌方法。在这种情况下，细菌群落（生物膜）是一个特别值得关注的问题。生物膜是造成大多数人类感染的原因，并且本质上不太容易受到抗生素治疗的影响。生物膜与几种具有挑战性的慢性疾病有关，包括植入物相关的骨髓炎和慢性伤口。受感染组织中存在的特定局部环境通过限制全身性抗生素治疗的功效和降低感染部位的药物浓度，进一步导致抗生素耐药性的上升，这可能导致再次发生感染。为了克服全身性药物递送的缺点，聚合物载体中的封装已被证明可以增强抗菌功效，在感染部位的渗透和滞留。在这篇综述中，我们概述了当前在聚合物载体中封装抗菌剂的策略，并在逐个组织的基础上比较了挑战和解决方案。我们从口腔、伤口、胃、泌尿道、骨、肺、阴道、眼和中/内耳组织中发现的生物膜的局部环境的角度比较了挑战并提出了药物输送解决方案。我们还将讨论这些疗法临床转化的未来挑战和障碍。以下评论表明，不同组织类型的研究重点之间存在显着的不平衡，一些目标（口腔和伤口生物膜）比其他目标（阴道和中耳炎生物膜和心内膜炎）得到更广泛的研究。此外，