Tackling microbial infections and increasing resistance involving formulations based on antimicrobial polymers

Antimicrobial polymers (APs) are the new type of disinfectants, which can be used in some cases as an alternative to nowadays overused antibiotics. This review presents the most prognostic approaches in tackling infections and drug resistance with application of antimicrobial polymers. We describe membrane-active formulations composed of antimicrobial polymers with attention paid to drug delivery systems and selected methods of visualization of the antimicrobial effect. Importantly, antimicrobial polymers can not only be used independently but as well they can be tethered to surfaces without losing their biological activity. The latter approach enables the design of surfaces that (i) inactivate microbes even without releasing additional biocides or (ii) enhance antimicrobial activity of these biocides acting by additive or synergistic effect. One of the hallmarks of APs is their low susceptibility to the current and/or emerging resistance mechanisms. Simplicity of modulation of the antimicrobial activity by easy changes in their structures and the related optimization of biological potential make the formulations composed of antimicrobial polymers clinically relevant materials.