## 7 Approaches to Prevent and Manage Infections Caused by Biofilms
### Antimicrobial Peptides  
Antimicrobial peptides (AMPs) use various methods to combat biofilms, primarily by destroying bacterial cell membranes. These peptides target different molecular components at various stages of biofilm development, employing unique modes of action. Studies have shown that AMPs can rupture bacterial cell membranes, as demonstrated by atomic force microscopy [271; 272]. In addition, AMPs have been found to physically damage bacterial cell membranes, ultimately leading to cell death. As a result, they are being explored as potential and effective antibacterial agents against biofilms [273]. Effective delivery methods are critical to maximizing the therapeutic potential of AMPs against biofilm-embedded pathogens. Nanoparticle-based delivery systems, for instance, encapsulate AMPs to protect them from enzymatic degradation while enhancing their penetration into the biofilm matrix. This approach ensures localized action and minimizes off-target effects [274; 275]. Hydrogel systems represent another promising method, enabling sustained and controlled AMP release directly at the infection site and maintain ing therapeutic concentrations over extended periods [276]. Additionally, self-assembling AMP-based nanostructures have shown potential in targeting biofilms, as they improve the stability of peptides and enhance their ability to interact with and disrupt biofilm components. These delivery innovations significantly enhance AMP efficacy, making them more robust tools for managing biofilm-associated infections [277]. In addition, the effect of AMPs on the control of genes linked to the formation of biofilms is an essential aspect of their antibacterial function. Particular AMPs are demonstrated to significantly influence biofilm formation by regulating genetic pathways that suppress biofilm development. The gene _YWP1_, exclusive to the yeast form of specific fungi such as _C. albicans_, and the gene _NRG1_, which produces a repressor of the filamentation pathway, have been recognized as crucial regulators in this process. Both genes demonstrate heightened activity when exposed to AMPs, resulting in improved suppression of biofilm formation [278]. Furthermore, studies have shown that AMPs can impede biofilm production by disrupting intercellular communication in bacteria. This disruption of QS, the communication system bacteria utilize to coordinate biofilm creation, reduces the ability to generate these protective structures [279]. In addition to their direct attack on pathogens, AMPs play a crucial role in regulating the immune response, thereby increasing the body's ability to combat illnesses associated with biofilms [271]. This dual ability of AMPs to directly attack microorganisms and enhance the immune response contributes significantly to their therapeutic effectiveness in treating infections linked to biofilms. Several peptides, including human-defensin 3 (hBD-3), sheep myeloid peptide (AMP-29), rat cathelin-related antimicrobial peptide (rCRAMP), and bovine myeloid antimicrobial peptide (BMAP-27), demonstrate potent microbicidal activity against pathogenic bacteria such as _E. coli_, _P. aeruginosa_, _MRSA_, and _A. baumannii_. These peptides also inhibit biofilm formation and regulate the host's immune system [280; 281]. Excitingly, the future development of AMPs as novel treatments involves creating multifunctional AMPs that integrate their direct antibacterial activity with additional functions like controlling the immune system response [282]. AMPs provide a powerful approach to targeting persister cells by disrupting bacterial membranes, bypassing conventional resistance mechanisms. Among recent developments, TM5, a broad-spectrum AMP, has shown notable efficacy in eliminating planktonic and persister cells in biofilms developed by Gram-positive and Gram-negative bacteria [283; 284]. Similarly, SAAP-148, an acyldepsipeptide, has demonstrated remarkable activity against _MRSA_ persisters in a prosthetic joint infection model [285].