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Peer-reviewedCC BY 4.0Advanced Biotechnology

Synergistic effect of zinc oxide nanoparticles and antibiotics: a strategy to combat bacterial resistance

  • Mariana Picchi Salto1
  • Natália Galvão de Freitas1
  • Fabrício Costa Fanhani2
  • Luana Mota Ferreira2
  • João Augusto Oshiro Junior3,4
  • Laurent Lemaire5,6
  • Jean Leandro dos Santos1
  • Leila Aparecida Chiavacci1
6 affiliations
  1. 1Pharmacy School, State University of São Paulo, Araraquara, SP Brazil
  2. 2Department of Pharmacy, Center of Health Sciences, Postgraduate Program in Pharmaceutical Sciences, Federal University of Paraná, Curitiba, PR Brazil
  3. 3Federal University of Paraiba, Postgraduate Program in Technological Development and Innovation in Medicines, João Pessoa, Paraíba Brazil
  4. 4Pharmaceutical Sciences Postgraduate Center for Biological and Health Sciences, State University of Paraíba, Campina Grande, Paraíba Brazil
  5. 5Univ Angers, INSERM, CNRS, MINT, SFR ICAT, Angers, F-49000 France
  6. 6Univ Angers, PRISM, SFR ICAT, Biogenouest, Angers, F-49000 France
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Abstract

Antimicrobial resistance (AMR) continues to compromise the clinical utility of conventional antibiotics, highlighting the need for innovative adjuvant strategies. Zinc oxide nanoparticles (ZnO-NP) have gained attention due to their intrinsic antimicrobial properties and capacity to potentiate antibiotic activity through multimodal mechanisms. This scoping review systematically mapped current evidence on ZnO-NP with antibiotics combinations (ZnO-NP-antibiotic) following the PRISMA-ScR guidelines. Searches in PubMed, Scopus, and Web of Science identified 14 eligible studies. To ensure comprehensive coverage of the literature, an additional manual search was conducted using Google Scholar and the reference lists of the included studies, and 10 further articles were identified. In total, 24 articles are included in this scoping review. Most investigations relied on simple physical mixtures (n = 13); while fewer explored conjugation between ZnO-NP-antibiotic (n = 3); encapsulated systems (n = 4); or drug-loaded (n = 4). Better antimicrobial activity was consistently reported across multiple antibiotic classes. Although all studies evaluated planktonic activity, only 10 incorporated biofilm models. Notably, translational maturity remains limited: more than half of the studies (n = 14) did not include toxicity assessment, and safety evaluation was considered based on in vitro cytotoxicity assays (n = 5); in vivo investigations (n = 5) or Hen's Egg Test—Chorioallantoic Membrane (HET-CAM) (n = 1). These findings indicate that ZnO-NP-antibiotic systems remain predominantly in the early stages of development. Future progress will require standardized antibiofilm methodologies, systematic toxicological profiling, pharmacokinetic characterization, and mechanistic validation to establish reproducible structure–activity relationships. Addressing these translational and regulatory challenges will determine whether nanoparticle-mediated synergy can advance beyond a laboratory proof-of-concept toward clinically viable antimicrobial strategies.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s44307-026-00137-4.

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Cite

BibTeXRIS
BibTeX
@article{salto2026synergistic,
  title = {{Synergistic effect of zinc oxide nanoparticles and antibiotics: a strategy to combat bacterial resistance}},
  author = {Mariana Picchi Salto and Natália Galvão de Freitas and Fabrício Costa Fanhani and Luana Mota Ferreira and João Augusto Oshiro Junior and Laurent Lemaire and Jean Leandro dos Santos and Leila Aparecida Chiavacci},
  journal = {Advanced Biotechnology},
  year = {2026},
  month = oct,
  doi = {10.1007/s44307-026-00137-4},
  url = {https://doi.org/10.1007/s44307-026-00137-4},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Synergistic effect of zinc oxide nanoparticles and antibiotics: a strategy to combat bacterial resistance
AU  - Mariana Picchi Salto
AU  - Natália Galvão de Freitas
AU  - Fabrício Costa Fanhani
AU  - Luana Mota Ferreira
AU  - João Augusto Oshiro Junior
AU  - Laurent Lemaire
AU  - Jean Leandro dos Santos
AU  - Leila Aparecida Chiavacci
PY  - 2026
DA  - 2026/10/26
JO  - Advanced Biotechnology
DO  - 10.1007/s44307-026-00137-4
UR  - https://doi.org/10.1007/s44307-026-00137-4
AB  - Antimicrobial resistance (AMR) continues to compromise the clinical utility of conventional antibiotics, highlighting the need for innovative adjuvant strategies. Zinc oxide nanoparticles (ZnO-NP) have gained attention due to their intrinsic antimicrobial properties and capacity to potentiate antibiotic activity through multimodal mechanisms. This scoping review systematically mapped current evidence on ZnO-NP with antibiotics combinations (ZnO-NP-antibiotic) following the PRISMA-ScR guidelines. Searches in PubMed, Scopus, and Web of Science identified 14 eligible studies. To ensure comprehensive coverage of the literature, an additional manual search was conducted using Google Scholar and the reference lists of the included studies, and 10 further articles were identified. In total, 24 articles are included in this scoping review. Most investigations relied on simple physical mixtures (n = 13); while fewer explored conjugation between ZnO-NP-antibiotic (n = 3); encapsulated systems (n = 4); or drug-loaded (n = 4). Better antimicrobial activity was consistently reported across multiple antibiotic classes. Although all studies evaluated planktonic activity, only 10 incorporated biofilm models. Notably, translational maturity remains limited: more than half of the studies (n = 14) did not include toxicity assessment, and safety evaluation was considered based on in vitro cytotoxicity assays (n = 5); in vivo investigations (n = 5) or Hen's Egg Test—Chorioallantoic Membrane (HET-CAM) (n = 1). These findings indicate that ZnO-NP-antibiotic systems remain predominantly in the early stages of development. Future progress will require standardized antibiofilm methodologies, systematic toxicological profiling, pharmacokinetic characterization, and mechanistic validation to establish reproducible structure–activity relationships. Addressing these translational and regulatory challenges will determine whether nanoparticle-mediated synergy can advance beyond a laboratory proof-of-concept toward clinically viable antimicrobial strategies.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s44307-026-00137-4.
SN  - 2948-2801
ER  -