Liposome drug delivery strategies: state-of-the-art for combating bacterial biofilms

Bacterial biofilms pose a significant challenge in clinical settings due to their inherent resistance to conventional antibiotics and host immune responses. This review comprehensively discusses the application of liposomal drug delivery systems as a cutting-edge strategy to combat biofilm-associated infections. It begins by outlining the biological characteristics of biofilms, including their formation process and the protective extracellular polymeric substance (EPS) matrix. The manuscript then focuses on the advantages of liposomes, such as their nanoscale size effect, modifiable surface properties, and sustained-release capabilities, which enhance penetration through the EPS and improve drug accumulation at infection sites. Furthermore, it details species-specific strategies against pathogens like Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. The review also covers advanced mechanisms including quorum sensing interference, stimuli-responsive release (pH, enzyme, temperature), and synergistic therapies combining antibiotics with antimicrobial peptides or natural products. Finally, it summarizes current clinical studies and outlines future prospects for precision targeting and multi-stimuli responsive systems to improve the treatment of chronic biofilm infections.