Alternating magnetic fields enhance anti-biofilm activity across pathogen and antibiotic space

Prosthetic joint infection (PJI) is a severe complication of total joint arthroplasty, contributing to significant patient morbidity and increased healthcare costs. The formation of biofilm on the implant hinders effective therapy, and removal of the prosthesis is frequently required. High frequency alternating magnetic fields (AMF) have emerged as a promising noninvasive approach to disrupt biofilm and have the potential to augment antibiotic activity. This study evaluated the impact of AMF on antibiotic activity in biofilms of clinically relevant PJI pathogens. Across multiple bacterial strains, AMF significantly improved biofilm eradication when administered with antibiotics, achieving greater reductions in bacterial burden compared to antibiotic monotherapy. There was an average reduction of 5.72-log across Gram-positive pathogens when treated with AMF and linezolid, and an average 5.11-log reduction of Gram-negative biofilm when treated with AMF and ciprofloxacin. The bactericidal response was independent of metal composition, suggesting broad applicability to different conductive prosthetic materials. Additionally, biofilm reduction was time and temperature-dependent, with peak efficacy observed at 80 °C. These findings support AMF as a potential adjunctive therapy for PJI, warranting further investigation in clinical settings to optimize treatment strategies and improve patient outcomes.