Background: The establishment of a biofilm by most pathogenic bacteria has been known
as one of the resistance mechanisms against antibiotics. A biofilm is a structural component where the
bacterial community adheres to the biotic or abiotic surfaces by the help of Extracellular Polymeric
Substances (EPS) produced by bacterial cells. The biofilm matrix possesses the ability to resist several
adverse environmental factors, including the effect of antibiotics. Therefore, the resistance of bacterial
biofilm-forming cells could be increased up to 1000 times than the planktonic cells, hence requiring a
significantly high concentration of antibiotics for treatment.
Methods: Up to the present, several methodologies employing antibiotics as an anti-biofilm, antivirulence
or quorum quenching agent have been developed for biofilm inhibition and eradication of a
pre-formed mature biofilm.
Results: Among the anti-biofilm strategies being tested, the sub-minimal inhibitory concentration of
several antibiotics either alone or in combination has been shown to inhibit biofilm formation and
down-regulate the production of virulence factors. The combinatorial strategies include (1) combination
of multiple antibiotics, (2) combination of antibiotics with non-antibiotic agents and (3) loading of
antibiotics onto a carrier.
Conclusion: The present review paper describes the role of several antibiotics as biofilm inhibitors and
also the alternative strategies adopted for applications in eradicating and inhibiting the formation of
biofilm by pathogenic bacteria.