The rise in antibiotic-resistant bacteria, including strains that are resistant to last-resort antibiotics, and the limited ability of antibiotics to eradicate biofilms have necessitated the development of alternative antibacterial therapeutics. Antibacterial biomaterials, such as polycationic polymers, and biomaterial-assisted delivery of non-antibiotic therapeutics, such as bacteriophages, antimicrobial peptides and antimicrobial enzymes, have improved our ability to treat antibiotic-resistant and recurring infections. Biomaterials not only allow targeted delivery of multiple agents but also sustained release at the infection site, thereby reducing potential systemic adverse effects. In this Review, we discuss biomaterial-based non-antibiotic antibacterial therapies for the treatment of community-acquired and hospital-acquired infectious diseases, with a focus on in vivo results. We highlight the translational potential of different biomaterial-based strategies and provide a perspective on the challenges associated with their clinical translation. Finally, we discuss the future scope of biomaterial-assisted antibacterial therapies.

抗生素耐药细菌的增加，包括对最后手段抗生素具有耐药性的菌株，以及抗生素根除生物膜的能力有限，需要开发替代的抗菌疗法。聚阳离子聚合物等抗菌生物材料和噬菌体、抗菌肽和抗菌酶等非抗生素疗法的生物材料辅助递送提高了我们治疗抗生素耐药性和复发性感染的能力。生物材料不仅可以靶向递送多种药物，还可以在感染部位持续释放，从而减少潜在的全身不良反应。在这篇评论中，我们讨论了基于生物材料的非抗生素抗菌疗法，用于治疗社区获得性和医院获得性传染病，重点是体内结果。我们强调了不同基于生物材料的策略的转化潜力，并就与其临床转化相关的挑战提供了一个视角。最后，我们讨论了生物材料辅助抗菌疗法的未来范围。