Recent Progress of Ultrasound Therapy for Antibacterial Applications.

Bacterial infections, especially deep-seated tissue infections caused by drug-resistant bacteria and the formation of biofilms, have become a major challenge in modern medicine. Traditional antibiotic treatment faces problems such as decreased efficiency, side effects, and further induction of drug resistance. Therefore, it is crucial to explore and develop new antibacterial methods that do not rely on traditional antibiotics. Ultrasound antibacterial therapy, as a non-invasive, highly tissue-penetrating and antibiotic-free novel treatment method, is gradually becoming a powerful weapon for solving multidrug-resistant (MDR) bacterial infections. Despite the significant advantages of ultrasound therapy in addressing MDR bacterial infections, its clinical translation for antimicrobial applications still faces numerous challenges. Starting from the potential mechanisms of ultrasound effects, this review discusses the specific strategies for optimizing ultrasound response performance. In addition, we also summarize the latest research progress on antibacterial mechanisms and applications of ultrasound therapy. Ultrasound therapy can be combined with other therapies such as phototherapy, chemodynamic therapy, gas therapy, ion therapy, and antimicrobial peptides for achieving improved antibacterial performance. Finally, the current challenges in clinical translation and future development directions of ultrasound antibacterial therapy were discussed.