Reimagining Chitosan-Based Antimicrobial Biomaterials to Mitigate Antibiotic Resistance and Alleviate Antibiotic Overuse: A Review

This paper reports recent advancements in chitosan-based antimicrobial biomaterials that aim to address the issue of antimicrobial resistance (AMR). Today, AMR is one of the most significant public health challenges the world is facing. To combat the overuse of antibiotics, a range of materials, including advanced nanosized polymers, have been explored as potential antimicrobial agents. In this direction, chitosan scores highly because of its unique combination of properties such as biodegradability, biocompatibility, bioactivity, non-toxic, and, most importantly, its intrinsic antibacterial and antifungal activity. Herein, an overview of chitosan and its derivatives as potential alternatives to conventional antimicrobial therapeutics is reported. This review starts with understanding the AMR mechanism, which is critical for developing suitable materials for treating infectious diseases. Then, the inherent characteristics, modes of antimicrobial action, and factors that impact the antimicrobial effectiveness of chitosan and its derivatives are discussed. The authors further summarize various clinical trial results of chitosan-based materials as antimicrobial agents. Finally, various antimicrobial applications of chitosan-based materials are reported. In summary, this review offers new insights into the design of chitosan-based sustainable materials for various antimicrobial applications.