Combined therapy with penicillins
and aminoglycosides has been
proved beneficial to address many persistent bacterial infections
with possible synergistic effects. However, the different pharmacokinetic
profiles of these two antibiotic classes may not guarantee a concerted
spatio-temporal delivery at the site of action, decreasing the efficacy
of this combination and promoting resistance. Herein, we propose a
multifunctional antibiotic–polymer conjugate, designed to colocalize
ampicillin and gentamicin to tackle persistent biofilm infections.
The two antibacterial molecules were grafted along with the amino
acid l-arginine to a biocompatible polymer backbone with
peptidomimetic hydrophilic structure, obtaining the antimicrobial
poly(argilylaspartamide-co-aspartic) acid–ampicillin, gentamicin
(PAA-AG) conjugate. The PAA-AG conjugate displayed excellent biocompatibility
on human cell lines if compared with free drugs, potentially enlarging
their therapeutic window and safety, and suitable mucoadhesive characteristics
which may help local treatments of mucosal infections. Studies on
planktonic cultures of clinical and reference strains of S. aureus, P. aeruginosa, and E. coli revealed that PAA-AG
holds a broad-spectrum antibacterial efficacy, revealing high potency
in inhibiting the growth of the tested strains. More interestingly,
PAA-AG exhibited excellent antibiofilm activity on both Gram+ and
Gram– communities, showing inhibition of their formation at
subMIC concentrations as well as inducing the regression of mature
biofilms. Given the high biocompatibility and broad antibiofilm efficacy,
combined with the opportunity for synchronous co-delivery, the PAA-AG
conjugate could be a valuable tool to increase the success of ampicillin/gentamicin-based
antibiotic multitherapy.