Antimicrobial Peptides in Preventive Medicine: Current Perspectives on Coating Strategies

The alarming rise of antimicrobial resistance and the declining efficacy of conventional antibiotics emphasize the need for preventive strategies. Within the setting of device-associated infections, antimicrobial peptides (AMPs) have been extensively studied as antimicrobial candidates, owing to their broad-spectrum activity and structural versatility, enabling integration into functional surface coatings. This review provides a comprehensive overview of AMP-based prophylactic approaches, with a particular focus on coatings for medical devices prone to biofilm formation, such as endotracheal tubes, catheters and implants. While surface immobilization of peptides can be accomplished through comparatively straightforward methodologies, the field has progressed toward sophisticated matrix-based systems that enhance stability, biocompatibility and controlled functionality. Yet, despite extensive in vitro and small-scale in vivo studies, clinical translation remains very limited and constrained by several hurdles including regulatory ambiguity and production costs. Overall, this work aims to provide an up-to-date overview of the AMP-based technologies in infection prevention research.