Breaking through the bacterial resistance defense line: "Trojan horse" antibiotic conjugates precision strike road

The emergence of bacterial resistance, especially the multidrug resistance of Gram-negative bacteria through gene mutation or horizontal gene transfer, has threatened global public health seriously. In response to this challenge, the "Trojan horse" strategy has been widely concerned as an innovative treatment means. By combining antibiotics with molecules necessary for bacterial survival, targeted delivery is achieved by using the bacteria's own nutrient uptake system, thereby bypassing the outer membrane barrier and drug resistance mechanism of bacteria. In this paper, the classification, research progress and specific mechanisms of antibiotic conjugates, including siderophore-antibiotics, peptide-antibiotics, antibody-antibiotics and nanoparticle-antibiotics, are described in detail. The potential and challenges of above strategies in clinical application and future research trends are also discussed.