Bone and joint infections
(BJIs) are difficult to treat, necessitating
antimicrobial therapy at high doses for an extended period of time,
in some cases different from our local guidelines. As a consequence
of the rise in antimicrobial-resistant organisms, drugs that were
previously reserved for last-line defense are now being used as first
line treatment, and the pill burden and adverse effects on patients
are leading to nonadherence, encouraging antimicrobial resistance
(AMR) to these last-resort medicines. Nanodrug delivery is the field
of pharmaceutical sciences and drug delivery which combines nanotechnology
with chemotherapy and/or diagnostics to improve treatment and diagnostic
outcomes by targeting specific cells or tissues affected. Delivery
systems based on lipids, polymers, metals, and sugars have been used
in an attempt to provide a way around AMR. This technology has the
potential to improve drug delivery by targeting the site of infection
and using the appropriate amount of antibiotics to treat BJIs caused
by highly resistant organisms. This Review aims to provide an in-depth
examination of various nanodrug delivery systems used to target the
causative agents in BJI.