Table 1.

Methods to overcome antibiotic resistance in biofilms.

Strategy	Mechanism	Methods or agents	Target Microorganisms
Physical destruction	Physical destruction of biofilm structure	UTMD [51] Surgical debridement plus antibiotic [52, 53]	S. epidermidis P. aeruginos
Target the EPS	Inhibit EPS production or secretion	cdGMP and cdAMP [56] Small molecules such as glucosyltransferase inhibitor and pilicides [57, 58]	S. aureus P. aeruginosa S. epidermidis Streptococcus
	Degrade EPS	Glucanohydrolases and dispersin B [59, 60] Esp serine protease [61] DNase I [62-64]	S. aureus P. aeruginosa S. epidermidis Streptococcus
Block quorum sensing	Inhibit quorum sensing to prevent biofilm formation	Blocking QS signal molecule production [66] Neutralizing signal molecules by chemicals, antibodies, or specific enzymes [41, 67] Blocking the receptors or inhibit the signaling pathway [42, 43]	P. aeruginosa B. Bosea sp. B. brevis A. caviae Sch3
Recombinant phages	Use phage to lyse bacteria	Recombinant ‘phage cocktail’ [76] Nature strains of polyvalent bacteriophages [77, 78]	Staphylococcus strains S. epidermidis S. aureus K. pneumoniae
Others	Use chemical or physical principles	Nanoparticles: TiO2 [82] ; Silver [83]	S. aureus, S. epidermidis, P. aeruginosa, E. coli, and C. abicans;
		Electric currents [84-88]	E. coli, P. aeruginosa, S. Typhimurium.

Promising methods to overcome biofilm antibiotic resistance, with the underlying mechanism of action also shown.