The ubiquity and potency of antibiotics may give the false impression that infection is a solved problem. Unfortunately, even bacterial infections, the target of antibiotics, remain a major cause of illness and death. Several major unmet needs persist: biofilms, such as those on implanted hardware, largely resist antibiotics; the inflammatory host response to infection often produces more damage than the infection itself; and systemic antibiotics often decimate the gut microbiome, which can predispose to additional infections and even predispose to non-infectious diseases. Additionally, there is an increasing threat from multi-drug resistant microorganisms, though market forces may continue to inhibit innovation in this realm. These numerous unmet infection-related needs provide attractive goals for innovation of targeted drug delivery technologies, especially those of nanomedicine. Here we review several of those innovations in pre-clinical development, the two such therapies which have made it to clinical use, and the opportunities for further technology development for treating infections.

抗生素的普遍性和效力可能会给人一种错误的印象，即感染问题已得到解决。不幸的是，即使是抗生素所针对的细菌感染，仍然是疾病和死亡的主要原因。几个主要的未满足的需求仍然存在：生物膜，例如植入硬件上的生物膜，很大程度上对抗生素具有抵抗力；宿主对感染的炎症反应通常比感染本身造成更多的损害；全身性抗生素通常会破坏肠道微生物组，从而导致额外的感染，甚至导致非传染性疾病。此外，尽管市场力量可能继续抑制这一领域的创新，但多重耐药微生物的威胁日益严重。这些众多未满足的感染相关需求为靶向药物输送技术，特别是纳米医学的创新提供了有吸引力的目标。在这里，我们回顾了临床前开发中的几项创新、已投入临床使用的两种此类疗法，以及进一步开发治疗感染技术的机会。