Sexually transmitted infections and urogenital-perinatal infections are significant health challenges owing to their asymptomatic nature, multidrug-resistant pathogens, and lack of effective vaccines. Surfactants are under investigation as potential antimicrobial agents and alternatives to traditional antibiotics. Here, we discovered that N-dodecylpyridinium bromide (C₁₂PB), a cationic quaternary ammonium surfactant, has very low potential to induce antimicrobial resistance with no antibiotic cross-resistance or inflammation in vitro. Therefore, we developed a preclinical antibiotic-free cationic surfactant-based cellulose hydrogel for treating sexually transmitted infections. The C₁₂PB-hydrogels provided sustained surfactant release, enhancing their biocompatibility and antibacterial activity without inflammation or epithelial disruption of the vaginal tract. In a preclinical model of Neisseria gonorrhoeae infection, a single application of the C₁₂PB-hydrogel showed a 2- to 3-fold reduction in infection. This lays the foundation for the future development of C₁₂PB-hydrogels for sexually transmitted infections, demonstrating potent antibacterial activity and minimal risk of antimicrobial resistance or inflammation.

性传播感染和泌尿生殖道围产期感染由于无症状、具有多重耐药性的病原体以及缺乏有效的疫苗，是重大的健康挑战。表面活性剂作为潜在的抗菌剂和传统抗生素的替代品正在接受研究。在这里，我们发现N-十二烷基溴化吡啶（C _{12 PB）是一种阳离子季铵表面活性剂，}在体外诱导抗菌药物耐药性的潜力非常低，并且不存在抗生素交叉耐药性或炎症。因此，我们开发了一种临床前不含抗生素的基于阳离子表面活性剂的纤维素水凝胶，用于治疗性传播感染。 C ₁₂ PB-水凝胶提供持续的表面活性剂释放，增强其生物相容性和抗菌活性，而不会引起阴道炎症或上皮破坏。在淋病奈瑟菌感染的临床前模型中，单次应用 C ₁₂ PB-水凝胶显示感染减少了 2 至 3 倍。这为未来开发用于性传播感染的 C ₁₂ PB 水凝胶奠定了基础，证明了其强大的抗菌活性和最小的抗菌耐药性或炎症风险。