Evolutionary Rationale for Phages as Complements of Antibiotics

Antibiotic-resistant bacterial infections are a major concern to public health. Phage therapy has been proposed as a promising alternative to antibiotics, but an increasing number of studies suggest that both of these antimicrobial agents in combination are more effective in controlling pathogenic bacteria than either alone. We advocate the use of phages in combination with antibiotics and present the evolutionary basis for our claim. In addition, we identify compelling challenges for the realistic application of phage–antibiotic combined therapy.

TrendsThe efficacy of new and old antibiotics could be preserved if combined with phages.Positive interactions have been observed between antibiotics and lytic phages in controlling bacterial pathogens both in vitro and in vivo.Phage–antibiotic combinations are capable of targeting multidrug-resistant bacteria but their underlying mechanisms remain to be discovered.Evolutionary biology provides a framework for understanding the interactions between antimicrobial agents and the successful management of bacterial pathogens, their resistance, and their virulence.Video Abstract To view the video inline, enable JavaScript on your browser. However, you can download and view the video by clicking on the icon belowHelp with MP4 filesOptionsDownload video (43591 K)