Antibiofilm Treatment for Onychomycosis and Chronic Fungal Infections Skin Appendage Disord 2018;4:136-140 - DOI:10.1159/000480023 Fig. 1. Planktonic growth versus biofilm formation. As microbial numbers reach a minimum density, biofilm formation begins with surface attachment and development of the protective extracellular matrix (ECM) resulting in differential phenotypic characteristics that lead to resistance to both antimicrobial agents (including antifungals) and the host immune system. © 2017 S. Karger AG, Basel