Ambroxol’s potential as an anti-biofilm against biofilm-forming microorganisms: in vitro and in vivo studies

Antimicrobial resistance is a growing concern in modern medicine, necessitating innovative approaches to combat biofilm-related infections. This systematic review explores the potential of ambroxol, a mucolytic agent, as an anti-biofilm agent both in vitro and in vivo. Ambroxol's diverse applications, including inhibiting biofilm formation, disrupting quorum sensing, and enhancing antibiotic efficacy, are investigated across various microbial species. This research used the Preferred Reporting Items for Systematic Reviews and Meta-analyses method to process the articles obtained. Articles were collected from 2012 to 2022 through various searches such as Scopus, ScienceDirect, and PubMed. Nine articles that met the inclusion and exclusion criteria were obtained. Results indicate that ambroxol's versatility inhibits biofilm formation, improves antibiotic effectiveness, and disrupts established biofilms. These findings suggest that ambroxol holds promise as a valuable tool in the ongoing battle against biofilm-associated infections, offering new treatment and management strategies. Keywords: ambroxol, anti-biofilm activity, antimicrobial biofilm forming, CLSM, ELISA Reader, MTT