Bacterial biofilms play an important role in urinary tract infections (UTIs), being responsible for persistence infections causing relapses and acute prostatitis. Bacterial forming biofilm are difficult to eradicate due to the antimicrobial resistant phenotype that this structure confers being combined therapy recommended for the treatment of biofilm-associated infections. However, the presence of persistent cells showing reduced metabolism that leads to higher levels of antimicrobial resistance makes the search for new therapeutic tools necessary. Here, a review of these new therapeutic approaches is provided including catheters coated with hydrogels or antibiotics, nanoparticles, iontophoresis, biofilm enzyme inhibitors, liposomes, bacterial interference, bacteriophages, quorum sensing inhibitors, low-energy surface acoustic waves, and antiadhesion agents. In conclusion, new antimicrobial drugs that inhibit bacterial virulence and biofilm formation are needed. 1. Urinary Tract Infections Urinary tract infections (UTIs) are one of the most important causes of morbidity and health care spending affecting persons of all ages, including young women, children, and the elderly. It is estimated that approximately 40% of women have had a UTI at some time in their lives [1]. These infections are traditionally classified based on clinical symptoms, laboratory data, and microbiological findings. UTIs are categorized as cystitis (infection of the lower urinary tract or bladder), pyelonephritis (infection affecting the upper urinary tract or the kidneys), and prostatitis (prostate inflammation) [2]. More recently, however, UTIs have been clinically classified into groups based on clinical factors and their impact on morbidity and treatment [3]. These categories are acute uncomplicated cystitis in young women, recurrent cystitis in young women, acute uncomplicated pyelonephritis in young women, complicated UTI, UTI related to indwelling catheters, UTI in men, and asymptomatic bacteriuria [3]. Sexually active young women are at greater risk of presenting UTIs (especially uncomplicated cystitis) due to their anatomy (short urethra) and certain behavioural factors. Uncomplicated cystitis is limited to a few pathogens, being the most frequent Escherichia coli, causing approximately 80% of cystitis [3]. Recurrent UTIs appear in more than 20% of young women with acute cystitis and are divided into relapse (if all the infections are caused by the same microorganism) and reinfection (if the episodes are caused by different microorganisms). Relapses are categorized as
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