Antibacterial Therapeutic Ions Incorporation into Bioactive Glasses as a Winning Strategy against Antibiotic Resistance

This work focuses on combating bacterial infections in bone tissue using metal elements embedded in bioactive glass. While there is an urgent need for alternative methods with a shrinking number of effective treatment options untouched by antimicrobial resistance, it is crucial to first understand the mechanisms of pathogenesis, persistence, and bacterial resistance in skeletal infection, and then develop effective counterstrategies and innovative alternatives. This review considers the role of antimicrobial metal ions, their mechanism of action, and their incorporation into bioactive glass formulations as these materials can serve as delivery platforms with the least possible complexities. Furthermore, the bacterial infection risk in bone is also examined with specific attention to antibiotic resistance and biofilm formation. This review sheds light on the most promising materials as novel antibacterial agents by presenting a wide range of possible bioactive glass formulations equipped with potential antibacterial ions and in vitro/ in vivo insights, and it also reinforces the importance of continuing studies to develop multi-faceted antibacterial bioactive glasses.