Ultrasound requires high power and longer treatment times to inactivate micro-organisms when compared to ultrasound combined with other technologies. Previous reports have shown that the effectiveness of ultrasound as a decontamination technology can be increased by combining it with another treatment such as pressure, heat and antimicrobial solutions. Assisted ultrasound, the combination of ultrasound with another technology, is more energy efficient, and it has less impact on the food properties. In this review paper, the power ultrasound antimicrobial mechanisms of action, the antimicrobial effects of ultrasound in combination with other physical processes and antimicrobial solutions are comprehensively discussed. Furthermore, the present interest on using these technologies as alternative processing and decontamination methods is presented. Research outputs on the application of ultrasound combined with physical processes are showcased including applications of thermosonication, manosonication, manothermosonication and osmosonication. Antimicrobial efficacy, energy requirements and optimal operation conditions of the different assisted ultrasound technologies are critically discussed, and their impact on the food industry for future applications is presented. Overall, this review paper highlights the importance and recent developments of assisted ultrasound for enhancing food safety.
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