NIR-Assisted Multimodal Strategies for Enhanced Antibacterial Therapy

Bacterial infections, particularly those caused by multidrug-resistant pathogens and biofilm formation, have significantly undermined the efficacy of conventional antibiotics, highlighting the urgent need for novel antibacterial strategies. NIR-driven photothermal (PTT) and photodynamic therapies (PDT) have emerged as promising non-antibiotic approaches due to their noninvasive nature and precise spatiotemporal controllability. However, single-modality NIR treatments remain constrained by potential thermal damage to healthy tissues and reduced efficacy within the infection microenvironment. To address these limitations, researchers have developed NIR-mediated multimodal strategies that integrate complementary mechanisms for synergistic antimicrobial effects. Despite increasing studies, a systematic overview of NIR-based synergistic antibacterial strategies remains lacking. This review provides the first comprehensive focus on the combined application of NIR-mediated PTT/PDT with gas therapy (GT), chemodynamic therapy (CDT), immunotherapy, antibiotic adjuvants, and sonodynamic therapy (SDT). We summarize recent advances, discuss how these approaches overcome resistance, disrupt biofilm barriers, enhance antibacterial efficiency, and promote wound healing, and highlight the current challenges and prospects for clinical translation in this rapidly evolving field.