Glycerol monolaurate (GML) is a natural surfactant with antimicrobial properties. At ϳ0.3 mM, both GML and its component lauric acid were bactericidal for antibiotic-resistant Staphylococcus aureus biofilms. With the use of MICs of antibiotics obtained from planktonic cells, GML and lauric acid acted synergistically with gentamicin and streptomycin, but not ampicillin or vancomycin, to eliminate detectable viable biofilm bacteria. Images of GML-treated biofilms suggested that GML may facilitate antibiotic interaction with matrix-embedded bacteria. G lycerol monolaurate monoester (GML) is a mild surfactant formed by glycerol and lauric acid. It is used as a preservative and emulsifier in the food and cosmetic industries and is generally recognized as safe (GRAS) for oral use by the FDA (1). GML can be considered a natural surfactant in humans, where lauric acid is converted into GML found in breast milk. Although its clinical usefulness has not been firmly established, GML has antimicrobial activity against enveloped viruses (2) and a variety of bacteria, including some Gram-negative bacteria and some Gram-positive bacteria such as Streptococcus spp. and Staphylococcus aureus (3, 4).In human infections, including those related to indwelling devices such as catheters, sutures, and stents, both the prevalence and the importance of bacterial biofilms are becoming increasingly recognized (5-7). Biofilms can be defined as surface-associated microbial communities that develop in liquid environments. Microbes within biofilms are often embedded in a hydrated matrix composed of an extracellular polymeric substance containing proteins, polysaccharides, lipids, and extracellular DNA (8, 9). Biofilms are typically resistant to therapeutic concentrations of antibiotics that are based in part on the MICs of planktonic cells (5, 6, 10). Thus, infected devices can be a therapeutic challenge and often require surgical removal.The antibacterial effect of GML in biofilms has received little attention. Using an in vitro model of S. aureus suture-associated biofilms, we investigated the antibacterial effect of GML alone as well as GML's ability to act synergistically with specific antibiotics. S. aureus RN6390 is a wild-type strain known to produce biofilms (11-13). Antibacterial agents (Sigma-Aldrich, Inc., St. Louis, MO) included gentamicin sulfate (GEN), streptomycin sulfate, ampicillin, and vancomycin. With the use of CLSI guidelines (14), the MICs for this S. aureus strain were 1 g/ml for GEN, 0.25 to 0.5 g/ml for ampicillin, 2 g/ml for vancomycin, and 32 g/ml for streptomycin. For experiments, stock solutions of GML and lauric acid (Sigma-Aldrich) were dissolved in biofilm growth medium, namely, 66% tryptic soy broth supplemented with 0.2% glucose (12). Stock GML (182 mM in chloroform) was stored in the dark at room temperature, and stock lauric acid (500 and 100 mM in 100% ethanol) was stored at 4°C. In working dilutions, residual concentrations of solvents had no effect on S. aureus viability. Suture-associated biofilms were ...