Nanoparticles in the treatment of urinary tract infections: a comprehensive review

Urinary tract infections (UTIs) remain among the most prevalent bacterial infections worldwide, complicated by biofilm formation, intracellular bacterial reservoirs, and escalating antimicrobial resistance (AMR). Conventional antibiotics often fail to eradicate persistent pathogens, leading to recurrent infections and increased healthcare burden. Nanotechnology offers innovative solutions by leveraging unique physicochemical properties of nanomaterials to overcome these limitations. This review synthesizes recent advances in metallic and metal oxide nanoparticles, polymeric and lipid nanocarriers, carbon based composites, nanozymes, and phototheranostic platforms for UTI management. We highlight mechanisms of action including membrane disruption, reactive oxygen species generation, biofilm penetration, and targeted intravesical delivery. Special emphasis is placed on catheter focused antibiofilm strategies, nano enabled diagnostics, and hybrid systems that combine therapeutic and diagnostic functions. Emerging platforms such as surface enhanced Raman scattering (SERS) nanochips, electrochemical nanosensors, and paper based devices demonstrate rapid, sensitive detection of uropathogens and biomarkers directly from urine. While preclinical studies show promising bactericidal activity and biofilm disruption, translational challenges persist, including urothelial compatibility, renal clearance, long term toxicity, and regulatory approval. Early clinical experience with coated catheters and intravesical nanotherapies is encouraging but requires validation in pragmatic trials. Overall, nanotechnology represents a transformative approach to UTI diagnosis and therapy, with potential to restore antibiotic efficacy, reduce recurrence, and improve patient outcomes. Future progress will depend on robust toxicology, standardized production, and integration with antimicrobial stewardship frameworks.