Effectiveness or Understanding: Where Does the Key to Defeating Biofilm and Produce an Impactful Article Lie?

Biofilms (BFs) bacteria are dramatically intensifying tolerance to conventional antibiotics, no longer effective. Therefore, the research for new antibiofilm (ABF) compounds are noticeably increasing the studies proliferation rate. In this regard, intriguing questions should raise to be debated. To this end, the problematics of BF, mainly in medical setting, have been afforded here in an original way, examining the tension “between efficacy and understanding”. Questions include: are BF mechanistic studies indispensable and strictly required especially at academic levels with poor economic support? When may a purely phenotypic approach still hold scientific value? Could be demonstrate empirical efficacy alone, sufficient for scientific relevance of the study? Do high costs, long times mechanistic insights, also associated to environmental issues, represent the necessary key to defeating BFs and the benchmark that determines the robustness and impact of ABF research? The state of the art of global challenge against BF, responsible for difficult-to-treat and even lethal chronic infection, has been provided. The available armamentarium of best functioning antibiotics/combinations has been discussed, while the correct way to investigate ABF mechanisms has been clarified. Among 102 studies on the ABF activity, considered, distributed in Tables and discussed, mechanistic investigations carried out correctly have been found in only 34 ones. Only efficacy screens, stopping at phenotypic descriptions, as reported in 68 out of 102 papers, are considered essential for discovering efficacious ABF compounds and are welcome by Editors and scientific community. Such approach represents the main trend of most recent literature and is strongly desirable for publication.