With
the emergence of drug-resistant bacteria and the formation
of biofilms by bacteria and fungi, microbial infections gradually
threaten global health. Natural antimicrobial peptides (AMPs) have
low susceptibility for developing resistance due to the membrane targeted
mechanism, but instability and high manufacturing cost limit their
applications in clinic. Bile acids, a group of steroids in the human
body, with high stability, biocompatibility, and inherent facial amphiphilic
structure similar to the characteristics of AMPs, have been applied
to the biological field, such as drug delivery systems, self-healing
hydrogels, antimicrobials, and so on. In this review, we mainly focus
on the different classes of bile acid-based antimicrobials in recent
years. Various designs and methods for the preparation of unimolecular
antimicrobials with bile acid skeletons are first introduced, including
coupling of primary amine, quaternary ammonium, and amino acid units
with bile acid skeletons. Some representative oligomeric antimicrobials,
including dimers of bile acids, are summarized. Finally, macromolecular
antimicrobials bearing some positive charges at the main chain or
side chain and interaction mechanisms of these bile acid-based antimicrobials
are discussed.