Phototherapy-based multifunctional nanoplatform for synergistic therapy against drug resistance bacteria: Progress, advances and challenges

The expanded and massive use of antibiotics endows bacteria with the ability to resist almost all kinds of antibiotics, and there is an urgent need to develop efficient alternative therapies with broad-spectrum-killing properties of drug-resistant bacteria. Synergistic antimicrobial means using photodynamic and photothermal forces, which has attracted much attention in recent years. The combination of phototherapy with antibiotics, sonodynamic, gases therapy and nanozymes not only solves the problems of shallow effective depth of interaction, hypoxia at the infection site and inflammation of the body, but also greatly improves the biosafety and the ability to destroy biofilms. At the same time, the development of high surface area, strong stability and high permeability of nanomaterials further broaden the application of synergistic phototherapy. In this article, we discuss the principle and bactericidal properties of various types of multifunctional nanoplatform-based synergistic therapeutics, as well as their recent advances in antimicrobials, anti-biofilms, loading ways, targeting methods, and gene expression. In addition, the various photosensitizer ingredients for antimicrobial therapy were also summarized. We hope this review will shed new light on the future design and applications of advanced synergistic phototherapy for antimicrobial-resistant bacteria.