Biophotonics for pathogen detection and therapy: optical biosensing, phototherapy, and translational perspectives

The rise of drug-resistant and emerging pathogens demands innovative approaches that integrate rapid diagnosis with precise therapy. This review provides a comprehensive and critical analysis of recent progress in biophotonics for managing infectious diseases, with a particular focus on integrated theranostic strategies and their pathways to clinical translation. We systematically evaluate state-of-the-art optical biosensors, including fluorescence, surface-enhanced Raman scattering, CRISPR-based systems, and microfluidic chips positioning them not as broad replacements for centralized molecular testing, but as rapid, phenotype revealing tools for frontline triage and point-of-care decision making. We emphasize synergistic designs, such as combined photothermal-chemodynamic therapy and phage-targeted platforms that bridge detection with targeted killing. Crucially, the review highlights the pragmatic challenges of clinical translation, including standardization, light penetration, and device integration. We conclude that the future of infectious disease management will be advanced by practical biophotonic systems that deliver precise, light-based interventions guided by timely diagnostics, offering a powerful complement to antimicrobial stewardship.