Table 1.

Anti-biofilm strategies

Anti-biofilm strategies		Mechanism of action	Examples
(A) Inhibition of biofilm initiation
1	Alteration of physical properties of biomaterials [86–88]	Alteration of hydrophobicity, surface charge	Hyaluronic acid, Hydrogel membranes, fluorinated silica/titanium coatings
2	Alteration of chemical properties of biomaterials [89–91]	Altering the exterior of biomaterial	Ion coatings, biocides, antibiotics
(B) Inhibition of biofilm establishment/Biofilm dispersals
1	Quorum quenchers [93, 95]	Disruption of the biofilm mode of existence	Meta-bromo-thiolactone, FS3, Daptomycin
2	Anti-Quorum sensing peptides [96]	Attenuate quorum sensing	RNA III-inhibiting peptide
(C) Biofilm eradicators
1	Destroy extracellular polymeric substances (EPS) [97]	Disruption of protective EPS to expose bacteria to antibacterial agents	Deoxyribonuclease I (DNase I), Dispersin B, Alginate lyase
2	Nanoparticles [98]	Creating artificial channels in EPS	Laser-induced nanobubbles, Magnetic nanoparticles
3	Antimicrobial peptides [99, 100]	Disruption of the cell membrane, inhibition of enzymatic activity	LL-37, Oritavancin
4	Quaternary ammonium compounds (QACs) [101–103]	Disruption of the bacterial membrane–cell lysis	Mono-/bis-/tris-QACs, XF-70, XF-73
5	Antimicrobial lipids [104, 105]	Cell lysis, disruption of electron transport chain, inhibition of bacterial enzymes	Glycerol monolaurate, Docosahexaenoic acid, Eicosapentaenoic acid
6	Bacteriophage [106–108]	Anti-biofilm mediators	PhilBB-PF 7A
7	Natural [109–112]	Variable	1. Plant extracts: Green tea, Dandasa, fresh garlic extract (FGE) 2. Honey: Sidr, Manuka 3. Essential oils: Cumin, Cinnamon oil
8	Novel/modified antibiotics [113–115]	Broad-spectrum antibiotics	Vancomycin-D-octaarginine (V-r8), Pentobra
9	Others [116, 117]	Adjuncts to enhance the sensitivity of conventional antibiotics	1. Electrochemical treatment: damage bacterial membrane 2. Cryogenic freezing