Increasing resistance of bacteria to antibiotics is a serious worldwide problem, and to combat resistant bacteria, new antibacterial approaches are to be developed. One alternative to traditional antibiotic therapy is photodynamic antimicrobial chemotherapy (PACT). PACT is based on excitation of photosensitizers (PS) capable of transferring the absorbed light energy to dissolved molecular oxygen causing generation of reactive oxygen species, which irreversibly damage bacterial cell components. The overall efficiency of PACT has been proven for Gram-positive and Gram-negative bacteria. The effectiveness of PACT can be increased by encapsulation of PS in liposomes providing more concentrated delivery of PS, enhanced cytotoxicity, improved pharmacokinetic properties, sustained release, and prolonged action of the PS. For continuous and reusable application, PS can be immobilized in polymers. Chemiluminescence, sonodynamic treatment, and radiofrequency irradiation allow to perform excitation of PS in the dark without external illumination, opening prospects for combating internal infections. Combination of PS with antibiotics can gain a synergistic effect, allowing in some cases to overcome the resistance of bacteria to antibiotics.
Part of the book: Microorganisms