Publisher Summary The binding of the bacterial adhesions to host receptors is a very dynamic process which signals many responses by the bacteria from host cells. Thus, fimbrial adhesions may be viewed as direct mediators of bidirectional signaling between bacteria and host cells. Future studies in this area should prove highly informative for the design of novel strategies to modulate these signaling pathways and to curb bacterial infections and their harmful sequelae. The development of anti-adhesion therapy targeted at the microbial lectins is hampered by the great difficulty in large-scale synthesis of the required inhibitory saccharides. An alternative is the use of glycomimetics, compounds that structurally mimic the inhibitory carbohydrates, and which may be more readily obtainable. Eventually, a cocktail of inhibitors or a polyvalent inhibitor needs to be used, since many infectious agents express multiple specificities. Pathogens employ multiple molecular mechanisms of adhesion to initiate infection and effective anti adhesion drugs may probably have to consist of a cocktail of inhibitors. The biotechnology required to achieve this goal is promising.