Bacteriocins as Alternative Antimicrobial Agents for Wound-Associated Infections: Mechanisms, Activity Against Biofilms and Translational Potential.

Background/Objectives: Skin and soft tissue infections (SSTIs) remain a major clinical challenge due to the increasing prevalence of antimicrobial resistance and biofilm-associated pathogens. Conventional antibiotics are often limited by reduced efficacy, recurrent infections, and disruption of the resident skin microbiota. Consequently, bacteriocins have emerged as promising alternative or adjunctive antimicrobial agents for the treatment of skin and wound infections. Methods: A literature review was conducted using the PubMed, Scopus, and Web of Science databases. Experimental in vitro, ex vivo, and in vivo studies investigating bacteriocins in skin and wound infection models were analyzed, with a focus on antimicrobial activity, antibiofilm efficacy, activity against antimicrobial-resistant pathogens, and formulation strategies designed to improve therapeutic performance. Results: Available evidence demonstrates that numerous bacteriocins exhibit potent antimicrobial activity against clinically relevant skin-associated pathogens, particularly Staphylococcus aureus, including methicillin-resistant strains (MRSA). Several bacteriocins also showed significant antibiofilm properties and synergistic interactions with conventional antibiotics, resulting in enhanced bacterial eradication and reduced risk of resistance development. Experimental infection models further support their therapeutic potential in wound-associated infections. Additionally, advanced delivery platforms, including hydrogels, wound dressings, nanofibers, and lipid-based nanoparticles, improved peptide stability, sustained release, and local antimicrobial efficacy. Conclusions: Bacteriocins are promising candidates for the prevention and treatment of skin and wound infections due to their antimicrobial and antibiofilm activity, low propensity for resistance development, and suitability for topical administration. However, further studies addressing formulation optimization, safety, pharmacokinetics, and clinical validation are required before bacteriocin-based therapies can enter routine clinical practice.