Dendrimers, synthetic, highly branched nanostructures with well-defined architecture and tunable surface functionality, have come as promising multi-target antimicrobial systems that allow dendrimers to overcome multiple bacterial resistance mechanisms simultaneously.
Abstract
Antibiotics are also regarded as transformative therapeutic agents that are rapidly
losing their clinical effectiveness because of the global escalation of antimicrobial resistance
(AMR). Irrational and extensive antibiotic use has accelerated the emergence of resistant
pathogens through mechanisms such as low membrane permeability, target modification, active
efflux, quorum–sensing–regulated virulence, and biofilm formation, which leads to increased
morbidity and mortality worldwide. This urgent crisis needs innovative, target-based therapeutic
techniques beyond conventional antibiotics. In this context, dendrimers, synthetic, highly
branched nanostructures with well-defined architecture and tunable surface functionality, have
come as promising multi-target antimicrobial systems. Dendrimers directly disrupt bacterial
cell membranes, which enhances permeability and promotes antibiotic penetration while
simultaneously interacting with critical resistance determinants, including penicillin-binding
proteins (PBPs), quorum sensing (QS) pathways, which are involved in virulence and biofilm
regulation, and efflux pumps responsible for drug expulsion. Multiple dendrimer classes, which
include poly (amid amine) (PAMAM), polypropylene imine (PPI), carbosilane, and peptide
dendrimers, have shown intrinsic antimicrobial activity and strong synergistic effects with
conventional antibiotics. Their internal cavities enable efficient drug encapsulation, and surface
modifications allow targeted delivery, improved pharmacokinetics, and enhanced activity against
both planktonic bacteria and biofilms. These properties allow dendrimers to overcome multiple
bacterial resistance mechanisms simultaneously. This review gives a focus on the antimicrobial
mechanisms, dendrimer design parameters, and pharmaceutical approaches that allow them to be
translated into next-generation anti-infective treatments
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