Antibiotic Nanoparticles-Loaded Wound Dressings Against Pseudomonas aeruginosa’s Skin Infection: A Systematic Review

María I Quiñones-Vico,1– 4,* Ana Ubago-Rodríguez,1– 3,* Ana Fernández-González,1– 3 Raquel Sanabria-de la Torre,2,5 Álvaro Sierra-Sánchez,1– 3,5 Trinidad Montero-Vilchez,2,6 Manuel Sánchez-Díaz,2,6 José L Arias,2,7,8 Salvador Arias-Santiago1– 4,6 1Cell Production and Tissue Engineering Unit, Virgen de las Nieves University Hospital, Granada, 18014, Spain; 2Instituto de Investigación Biosanitaria Granada ibs.GRANADA, Granada, 18014, Spain; 3Andalusian Network of Design and Translation of Advanced Therapies, Sevilla, 41092, Spain; 4Medicine Department, School of Medicine, University of Granada, Granada, 18016, Spain; 5Department of Biochemistry and Molecular Biology IIi and Immunology, School of Medicine, University of Granada, Granada, 18016, Spain; 6Dermatology Department, Virgen de las Nieves University Hospital, Granada, 18014, Spain; 7Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, University of Granada, Granada, 18071, Spain; 8Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, 18100, Spain*These authors contributed equally to this workCorrespondence: Ana Fernández-González, Email ana.fernandez.gonzalez@juntadeandalucia.esAbstract: Pseudomonas aeruginosa (P. aeruginosa) is a common nosocomial pathogen that can cause severe infections in critically ill patients. Due to its resistance to multiple drugs, it is challenging to treat, which can result in serious illness and death. Conventional treatments for infected wounds often involve the topical or systemic application of antibiotics, which can lead to systemic toxicity and the development of drug resistance. The combination of wound dressings that promote wound healing with nanoparticles (NPs) represents a revolutionary strategy for optimizing the safety and efficacy of antibiotics. This review assesses a systematic search to identify the latest approaches where the evaluation of wound dressings loaded with antibiotic NPs is conducted. The properties of NPs, the features of wound dressings, the antimicrobial activity and biocompatibility of the different strategies are analyzed. The results indicate that most research in this field is focused on dressings loaded with silver NPs (57.1%) or other inorganic materials (22.4%). Wound dressings loaded with polymeric NPs and carbon-based NPs represent 14.3% and 6.1% of the evaluated studies, respectively. Nevertheless, there are no clinical trials that have evaluated the efficacy of NPs-loaded wound dressings in patients. Further research is required to ensure the safety of these treatments and to translate the findings from the bench to the bedside. Keywords: hydrogel, skin infection, wound dressing, P. aeruginosa, nanoparticles