Dinithi Senanayake, Imalka Munaweera
The rapid escalation of antimicrobial resistance (AMR) represents a major global health challenge, undermining the clinical efficacy of conventional antibiotics and driving the demand for alternative therapeutic strategies. Advances in nanoscience have positioned nanoscale materials as a powerful platform for the development of next generation antimicrobial systems, owing to their precisely tunable physicochemical features and ability to operate through multiple resistance evasive modes of action. This review provides a comprehensive overview of recent progress in antimicrobial nanomaterials, encompassing metallic and metal oxide nanoparticles, polymeric and carbon based nanostructures, as well as multifunctional hybrid architectures. Key antimicrobial mechanisms, including controlled ion release, reactive oxygen species generation, membrane perturbation, and synergistic chemical and physical interactions at the nano bio interface, are critically discussed. Particular attention is given to the growing class of stimuli responsive and smart nanomaterials that enable spatiotemporal activation, enhanced targeting, and improved therapeutic precision. The integration of antimicrobial functionality with anti-inflammatory, regenerative, and diagnostic capabilities highlights the versatility of nanoscale systems for biomedical applications such as wound management, implant surface engineering, biofilm mitigation, and targeted drug delivery. Despite significant advances, challenges related to cytocompatibility, biodegradability, scalable manufacturing, and regulatory harmonization remain. Finally, emerging directions including nanozymes, metal organic frameworks, artificial intelligence assisted material design, and antimicrobial 3D printed nanocomposites are discussed, underscoring the pivotal role of nanoscale innovation in addressing AMR and advancing future antimicrobial technologies.