Phage-antibiotic synergism: a possible approach to combatting Pseudomonas aeruginosa

Pseudomonas aeruginosa is a highly resistant opportunistic pathogen and an important etiological agent of various types of infections. During the last decade, P. aeruginosa phages have been extensively examined as alternative antimicrobial agents. The aim of the study was to determine antimicrobial effectiveness of combining subinhibitory concentrations of gentamicin, ceftriaxone, ciprofloxacin or polymyxin B with P. aeruginosa-specific bacteriophages belonging to families Podoviridae and Siphoviridae. The time-kill curve method showed that a combination of bacteriophages and subinhibitory concentrations of ceftriaxone generally reduced bacterial growth, and synergism was proven for a Siphoviridae phage σ-1 after 300 min of incubation. The detected alteration in morphology after ceftriaxone application, resulting in cell elongation, along with its specific mode of action, seemed to be a necessary but was not a sufficient reason for phage-antibiotic synergism. The phenomenon offers an opportunity for future development of treatment strategies for potentially lethal infections caused by P. aeruginosa.