In a previous development stage, mostly individual antibacterial
activity was a target in the optimization of biologically active compounds
and antiseptic agents. Although this targeting is still valuable,
a new trend has appeared since the discovery of superhigh resistance
of bacterial cells upon their aggregation into groups. Indeed, it
is now well established that the great majority of pathogenic germs
are found in the environment as surface-associated microbial communities
called biofilms. The protective properties of biofilms and microbial
resistance, even to high concentrations of biocides, cause many chronic
infections in medical settings and lead to serious economic losses
in various areas. A paradigm shift from individual bacterial targeting
to also affecting more complex cellular frameworks is taking place
and involves multiple strategies for combating biofilms with compounds
that are effective at different stages of microbiome formation. Quaternary
ammonium compounds (QACs) play a key role in many of these treatments
and prophylactic techniques on the basis of both the use of individual
antibacterial agents and combination technologies. In this review,
we summarize the literature data on the effectiveness of using commercially
available and newly synthesized QACs, as well as synergistic treatment
techniques based on them. As an important focus, techniques for developing
and applying antimicrobial coatings that prevent the formation of
biofilms on various surfaces over time are discussed. The information
analyzed in this review will be useful to researchers and engineers
working in many fields, including the development of a new generation
of applied materials; understanding biofilm surface growth; and conducting
research in medical, pharmaceutical, and materials sciences. Although
regular studies of antibacterial activity are still widely conducted,
a promising new trend is also to evaluate antibiofilm activity in
a comprehensive study in order to meet the current requirements for
the development of highly needed practical applications.