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We established a new approach to study <jats:italic>Pseudomonas aeruginosa<\/jats:italic> biofilm susceptibility on biotic surfaces, using a three-dimensional (3-D) lung epithelial cell model. <jats:italic>P. aeruginosa<\/jats:italic> formed antibiotic resistant biofilms on 3-D cells without affecting cell viability. The biofilm-inhibitory activity of antibiotics and\/or the anti-biofilm peptide DJK-5 were evaluated on 3-D cells compared to a plastic surface, in medium with and without fetal bovine serum (FBS). In both media, aminoglycosides were more efficacious in the 3-D cell model. In serum-free medium, most antibiotics (except polymyxins) showed enhanced efficacy when 3-D cells were present. In medium with FBS, colistin was less efficacious in the 3-D cell model. DJK-5 exerted potent inhibition of <jats:italic>P. aeruginosa<\/jats:italic> association with both substrates, only in serum-free medium. DJK-5 showed stronger inhibitory activity against <jats:italic>P. aeruginosa<\/jats:italic> associated with plastic compared to 3-D cells. The combined addition of tobramycin and DJK-5 exhibited more potent ability to inhibit <jats:italic>P. aeruginosa<\/jats:italic> association with both substrates. In conclusion, lung epithelial cells influence the efficacy of most antimicrobials against <jats:italic>P. aeruginosa<\/jats:italic> biofilm formation, which in turn depends on the presence or absence of FBS.<\/jats:p>","DOI":"10.1038\/srep43321","type":"journal-article","created":{"date-parts":[[2017,3,3]],"date-time":"2017-03-03T13:19:02Z","timestamp":1488547142000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":85,"title":["Antimicrobial efficacy against Pseudomonas aeruginosa biofilm formation in a three-dimensional lung epithelial model and the influence of fetal bovine serum"],"prefix":"10.1038","volume":"7","author":[{"given":"Aur\u00e9lie","family":"Crabb\u00e9","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nele","family":"Matthijs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Rigole","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9sar","family":"De La Fuente-N\u00f9\u00f1ez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria A.","family":"Ledesma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shameema","family":"Sarker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob","family":"Van Houdt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E. 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