Nanovesicular Drug Delivery Systems for Overcoming Antibiotic Resistance.

Despite the early success of treating bacterial infections with antibiotics, resistance development has become a global problem. Treatment of organisms that have become resistant to common antibacterial agents is challenging and can cause severe and extended illness, longer hospital stays, and increased medical costs. Bacteria may develop antibiotic resistance by multiple biochemical pathways, including target-site gene mutations, decreased permeability, drug uptake or efflux mechanisms that remove the drug from the host cells, and alterations in metabolic pathways. Several strategies to overcome antibacterial resistance are under investigation, such as modifying existing antibiotics, targeting bacterial enzymes, cell-penetrating antibiotics, nanoparticle drug delivery systems, and encapsulating antibiotics and macrophage-targeted nanoparticles conjugated with specific ligands. Among all these approaches, the nano-sized drug delivery systems have become the subject of intense investigations because of their special benefits, including increased stability of the antibiotic, enhanced permeation through cell membranes, and delivery inside the cytoplasm, as well as improved biodistribution and pharmacokinetics. This review compiles data on liposomes and niosomes, promising nanovesicular drug delivery systems capable of targeting antibiotics to fight resistant microorganisms.