Graphene oxide in antibiotic delivery and synergistic antibacterial action

Abstract

The rise of antibiotic-resistant bacteria has created an urgency to develop advanced antibiotic delivery systems. Nanoscience can address this issue by providing nanocarriers that enhance efficiency and minimize side effects in antibiotic delivery. Nanoparticle-based delivery systems can mechanistically combat antibiotic resistance by improving intracellular antibiotic delivery and antibiotic concentrations, protecting antibiotics from enzymatic degradation, increasing penetration into bacterial biofilms, and targeting antibiotics, unlike conventional antibacterial strategies, which lack these capabilities. An ideal antibiotic nanocarrier, therefore, requires a high antibiotic-loading capacity, controlled and stimuli-responsive release, intrinsic antibacterial activity, biocompatibility, and surface functionalization for targeted delivery. Graphene Oxide (GO) meets all these criteria due to its unique physicochemical properties. It has emerged as a promising antibiotic nanocarrier that offers high drug-loading capacity, tunable surface chemistry, and multifunctional antibacterial mechanisms. However, its performance is strongly dependent on dose, lateral size, oxidation degree, and surface functionalization, leading to inconsistent reports on efficacy, toxicity, and translational feasibility. This review describes GO's prominent role in antibiotic delivery and its synergistic action with antibiotics to combat antibiotic-resistant bacterial strains, while critically analyzing the mechanistic interactions between GO and antibiotics, the variability in reported biological outcomes, and the limitations of existing studies. Finally, key trends and unresolved controversies, including GO-antibiotic synergy and antagonism, and translational challenges related to stability, toxicity, and scalability, are critically discussed to guide future research on prospects of GO in antibiotic delivery against multidrug-resistant bacteria and define realistic pathways toward pharmaceutical and clinical development.