OP-145 is a synthetic antimicrobial peptide derived from amino acid sequence 13-36 of human cathelicidin LL-37, further modified to favour the formation of an amphipathic helix. To improve stability against proteolytic degradation, the N-terminus is acetylated and the C-terminus amidated. OP-145 is a potent antibacterial, only lytic to human cells at high concentrations, and shows significant activity against nine methicillin-resistant Staphylococcus aureus (MRSA) strains, reducing their growth and biofilm formation. OP-145 is safe and effective against chronic middle ear infection (otitis media) in humans, and when formulated in poly(lactic-co-glycolic acid) (PLGA) microspheres, OP-145 exerts strong anti-biofilm effects on clinical isolated pathogens and exerts powerful anti-infection effects in vivo.