Polymers showing intrinsic antimicrobial activity

Pathogenic microorganisms are considered to a major threat to human health, impinging on multiple sectors including hospitals, dentistry, food storage and packaging, and water contamination. Due to the increasing levels of antimicrobial resistance shown by pathogens, often caused by long-term abuse or overuse of traditional antimicrobial drugs, new approaches and solutions are necessary. In this area, antimicrobial polymers are a viable solution to combat a variety of pathogens in a number of contexts. Indeed, polymers with intrinsic antimicrobial activities have long been an intriguing research area, in part, due to their widespread natural abundance in materials such as chitin, chitosan, carrageen, pectin, and the fact that they can be tethered to surfaces without losing their antimicrobial activities. In addition, since the discovery of the strong antimicrobial activity of some synthetic polymers, much work has focused on revealing the most effective structural elements that give rise to optimal antimicrobial properties. This has often been synthesis targeted, with the generation of either new polymers or the modification of natural antimicrobial polymers with the addition of antimicrobial enhancing modalities such as quaternary ammonium or guanidinium groups. In this review, the growing number of polymers showing intrinsic antimicrobial properties from the past decade are highlighted in terms of synthesis; often based on post-synthesis modification and their utilization. This includes as surface coatings, for example on medical devices, such as intravascular catheters, orthopaedic implants and contact lenses, or directly as antibacterial agents (specifically as eye drops). Surface functionalisation with inherently antimicrobial polymers is highlighted and has been achieved via various techniques, including surface-bound initiators allowing RAFT or ATRP surface-based polymerization, or via physical immobilization such as by layer-by-layer techniques. This article also covers the mechanistic modes of action of intrinsic antimicrobial polymers against bacteria, viruses, or fungi.