Bacterial
resistance caused by the overuse of antibiotics and the
shelter of biofilms has evolved into a global health crisis, which
drives researchers to continuously explore antimicrobial molecules
and strategies to fight against drug-resistant bacteria and biofilm-associated
infections. Cationic antimicrobial peptides (AMPs) are considered
to be a category of potential alternative for antibiotics owing to
their excellent bactericidal potency and lesser likelihood of inducing
drug resistance through their distinctive antimicrobial mechanisms.
In this review, the hitherto reported plentiful action modes of AMPs
are systematically classified into 15 types and three categories (membrane
destructive, nondestructive membrane disturbance, and intracellular
targeting mechanisms). Besides natural AMPs, cationic polypeptides,
synthetic polymers, and biopolymers enable to achieve tunable antimicrobial
properties by optimizing their structures. Subsequently, the applications
of these cationic antimicrobial agents at the biointerface as contact-active
surface coatings and multifunctional wound dressings are also emphasized
here. At last, we provide our perspectives on the development of clinically
significant cationic antimicrobials and related challenges in the
translation of these materials.