Triggerable biomaterials-based osteomyelitis theranostics

The emergence of multidrug-resistant bacteria poses a significant challenge in the treatment of osteomyelitis, rendering traditional antibiotic treatment strategies inadequate in terms of achieving a complete cure. In recent years, triggerable biomaterial-based, antibiotic-free osteomyelitis treatment strategies have rapidly evolved, demonstrating excellent bactericidal effects. Triggerable biomaterials-based osteomyelitis theranostics encompass physical signal response strategies and host immune modulation approaches. These strategies can be effective against drug-resistant bacteria, circumventing the gradual acquisition of resistance that often accompanies traditional antibiotic treatment. Additionally, the inherent physical properties of the triggerable biomaterials facilitate the precise imaging of osteomyelitis. There is no doubt that triggerable biomaterial-mediated, antibiotic-free therapies are emerging as a trend, which is critically important in combating multidrug-resistant bacteria-induced osteomyelitis. In this review, we summarize the latest advances in osteomyelitis treatment strategies from both pathogen-directed and host-directed perspectives. The design regimens and specific action mechanisms of triggerable biomaterial-based nanoplatforms are also clarified. Finally, we outline the challenges faced by various antibiotic-free therapies and provide an outlook on the prospects for synergistic interactions.