Table 1.

Summary of therapeutic strategies against P. aeruginosa infections.

Therapeutic Approach	Activity	Advantages	Limitation	References
Antimicrobial peptides	Antibacterial Antibiofilm Immunological modulator	Low cytotoxicity Combined treatment possibility Low resistance	Sensitive to salt, serum and pH Susceptible to host proteolysis Expensive production	[139,140,141,142,143,144]
Antibiotics	Antibacterial	Inhaled antibiotic class Broad-spectrum Safety Improvement of lung function in CF patients	Resistance development	[145]
Lectin inhibitor	Antibiofilm	High stability Low resistance	No in vivo data Toxicity Narrow spectrum	[146,147,148]
Bacteriophages	Antibacterial	Delivery at the infection site High specificity Fewer side effects Easy administration	Poor stability Undesired cytotoxicity Resistance development Insufficient pharmacokinetics and pharmacodynamics data	[149,150,151,152,153]
Natural products	Antibacterial Antibiofilm Quorum sensing modulator	Broad-spectrum Multiple mechanisms of action	Cytotoxicity Resistance development Limited penetration into biofilm Limited killing effects on slow-growing bacteria Availability and Complex extraction and isolation	[154]
Nanoparticles	Antibacterial Antibiofilm	Broad-spectrum Combination with antibiotics/therapeutic agents Small size, thus direct delivery to targets	Cytotoxicity Host metabolism of nanoparticles	[155,156]
Nanocarriers (Liposomes, solid lipid and polymeric)	Drug delivery	Protection of therapeutic agents from inactivation and degradation by bacterial and host system Enhancement of efficacy Penetrability into the biofilm matrix	Cytotoxicity Host metabolism of nanoparticles	[157,158,159]
EPS inhibitors	Anti-EPS	Biofilm matrix degradation Limited/no effect on bacterial viability Low risk of resistance development Augmentation of antibiotic efficacy to clear the infection	Incomplete biofilm matrix disruption Cytotoxicity	[35,160,161]
Biofilm dispersers	Dispersal induction	Augmentation of antibiotic efficacy to clear the infection Promotion of self-disassembly Low risk of resistance development	Release of harmful dispersed cells for re-colonization and lethal septic event Cytotoxicity	[66,162]
QS inhibitors	Biofilm prevention Biofilm inhibition	Reduction of virulence factors No effect on bacterial viability	Narrow spectrum Unwanted effect on bacteria	[163,164,165]
Iron chelator	Interference with iron metabolism	Bactericidal activity Biofilm prevention Low risk of resistance development	Cytotoxicity	[166,167]
Photodynamic therapy	Antibacterial Antibiofilm	No resistance development Improved selectivity No photocytotoxicity	Potential side effects (e.g., burns, redness swelling of treated skin)	[168,169,170,171,172]
Photothermal therapy	Antibacterial Antibiofilm	No resistance development Improved selectivity Negligible cytotoxicity	Photothermal ablation of host tissues	[173,174,175,176]