• Oana Ciofu, Tim Tolker-Nielsen, Peter Østrup Jensen, Hengzhuang Wang, and Niels Høiby.
• Institute of International Health, Immunology and Microbiology, Costerton Biofilm Centre, University of Copenhagen, Copenhagen, Denmark.
• Adv. Drug Deliv. Rev. 2015 May 1; 85: 7-23.

AbstractLung infection is the main cause of morbidity and mortality in patients with cystic fibrosis and is mainly dominated by Pseudomonas aeruginosa. The biofilm mode of growth makes eradication of the infection impossible, and it causes a chronic inflammation in the airways. The general mechanisms of biofilm formation and antimicrobial tolerance and resistance are reviewed. Potential anti-biofilm therapeutic targets such as weakening of biofilms by quorum-sensing inhibitors or antibiotic killing guided by pharmacokinetics and pharmacodynamics of antibiotics are presented. The vicious circle of adaptive evolution of the persisting bacteria imposes important therapeutic challenges and requires development of new drug delivery systems able to reach the different niches occupied by the bacteria in the lung of cystic fibrosis patients. Copyright © 2014 Elsevier B.V. All rights reserved.

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