Hyperbaric oxygen therapy: Antimicrobial mechanisms and clinical application for infections

Biomed Pharmacother. 2019 Jan:109:440-447. doi: 10.1016/j.biopha.2018.10.142. Epub 2018 Nov 3.


Hyperbaric oxygen therapy (HBOT) is a treatment procedure that involves breathing 100% O2 for a certain time and under a certain pressure. HBOT is commonly administrated as a primary or alternative therapy for different diseases such as infections. In this paper, we reviewed the general aspect of HBOT procedures, the mechanisms of antimicrobial effects and the application in the treatment of infections. Parts of the antimicrobial effects of HBOT are believed to result of reactive from the formation of reactive oxygen species (ROS). It is also said that HBOT enhances the antimicrobial effects of the immune system and has an additive or synergistic effect with certain antimicrobial agents. HBOT has been described as a useful procedure for different infections, particularly in deep and chronic infections such as necrotizing fasciitis, osteomyelitis, chronic soft tissue infections, and infective endocarditis. The anti-inflammation property of HBOT has demonstrated that it may play a significant role in decreasing tissue damage and infection expansion. Patients treated by HBOT need carful pre-examination and monitoring. If safety standards are strictly tracked, HBOT can be considered a suitable procedure with an apt rate of complication.

Keywords: Hyperbaric oxygen therapy; Infection; Inflammation; Reactive oxygen species.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Infective Agents / administration & dosage
  • Combined Modality Therapy / methods
  • Combined Modality Therapy / trends
  • Communicable Diseases / immunology
  • Communicable Diseases / metabolism*
  • Communicable Diseases / therapy*
  • Humans
  • Hyperbaric Oxygenation / methods*
  • Hyperbaric Oxygenation / trends
  • Reactive Oxygen Species / immunology
  • Reactive Oxygen Species / metabolism*


  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Reactive Oxygen Species