Comparative efficacy: Antibiotics in Biofilms

• Bacteria develop a biofilm for survival in all environments
• Colonies of bacteria take at least 48 hours to establish biofilms
• Most antibiotics cannot penetrate biofilms
• Lab testing must be done before colonies develop biofilm
• some antibiotics work by inhibiting biofilm, e.g. azithromycin
• Ciprofloxacin is very active against Ps, cannot penetrate biofilm
• old floxacins; less active on Gram+ (staph, strep)
• new floxacins, easy development of resistant Gram+
• Ps are found below the water line in all N.American toilets tested
• Ps can live in pure bleach, betadyne, once biofilm establishes
• Biofilms make most antibiotic therapies ineffective
• Biofilm related: auto-immune diseases, chronic diseases
• Combinations of antibiotics work better than mono-therapy
• Biofilms allow distant communications, like a nervous system between colonies, potassium appears to be Transient Receptor Potential (TRP)

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