Diverse Antibacterial Treatments beyond Antibiotics for Diabetic Foot Ulcer Therapy

Adv Healthc Mater. 2023 Sep;12(23):e2300375. doi: 10.1002/adhm.202300375. Epub 2023 May 14.

Abstract

Diabetic foot ulcer (DFU), a common complication of diabetes, has become a great burden to both patients and the society. The delayed wound closure of ulcer sites resulting from vascular damage and neutrophil dysfunction facilitates bacterial infection. Once drug resistance occurs or bacterial biofilm is formed, conventional therapy tends to fail and amputation is unavoidable. Therefore, effective antibacterial treatment beyond antibiotics is of utmost importance to accelerate the wound healing process and prevent amputation. Considering the complexity of multidrug resistance, biofilm formation, and special microenvironments (such as hyperglycemia, hypoxia, and abnormal pH value) at the infected site of DFU, several antibacterial agents and different mechanisms have been explored to achieve the desired outcome. The present review focuses on the recent progress of antibacterial treatments, including metal-based medications, natural and synthesized antimicrobial peptides, antibacterial polymers, and sensitizer-based therapy. This review provides a valuable reference for the innovation of antibacterial material design for DFU therapy.

Keywords: antibacterial polymers; antibacterials; antimicrobial peptides; diabetic foot ulcers; metal nanoparticles; sensitizer-based therapy.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections* / drug therapy
  • Diabetes Mellitus* / drug therapy
  • Diabetic Foot* / complications
  • Diabetic Foot* / drug therapy
  • Humans
  • Treatment Outcome
  • Wound Healing

Substances

  • Anti-Bacterial Agents