Combined Forces Against Bacteria: Phages and Antibiotics

ABSTRACT Background and Aim It is now known that bacteria are highly interactive and exhibit a range of complex cooperative behaviors, including conjugal plasmid transfer, toxins, swarming, drug resistance, toxin production, biofilm development, and other virulence traits. The development of phage–a...

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Main Authors: Shima Afrasiabi, Alireza Partoazar, Ramin Goudarzi, Ahmad Reza Dehpour
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:Health Science Reports
Subjects:
Online Access:https://doi.org/10.1002/hsr2.70956
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author Shima Afrasiabi
Alireza Partoazar
Ramin Goudarzi
Ahmad Reza Dehpour
author_facet Shima Afrasiabi
Alireza Partoazar
Ramin Goudarzi
Ahmad Reza Dehpour
author_sort Shima Afrasiabi
collection DOAJ
description ABSTRACT Background and Aim It is now known that bacteria are highly interactive and exhibit a range of complex cooperative behaviors, including conjugal plasmid transfer, toxins, swarming, drug resistance, toxin production, biofilm development, and other virulence traits. The development of phage–antibiotic synergy (PAS) could be a useful weapon against bacterial infections where antibiotics increase phage replication and antimicrobial activity. This study investigates the therapeutic potential of PAS in combating bacterial infections, focusing on the mechanisms and clinical implications. Methods A comprehensive review of recent literature was conducted analyzing studies on PAS, including their effects on biofilm degradation, multidrug‐resistant (MDR) bacteria, and toxin‐producing pathogens. Key factors such as timing, dosing and compatibility of phage‐antibiotic combinations were examined. Results PAS showed promising results in various bacterial infections. The combination of phages and antibiotics restored the susceptibility of MDR strains, facilitated the degradation of biofilms and minimized the need for high doses of antibiotics, thereby reducing potential side effects. However, challenges such as the emergence of resistance and antagonistic interactions with certain combinations remain. Key factors influencing the efficacy of PAS include phage and antibiotic dosing, timing of administration, and the physiological state of the bacteria. Conclusion PAS has potential applications in the treatment of complex infections. Despite the promising results, further research is essential to standardize protocols, optimize therapeutic combinations and address safety concerns. Clinical trials focusing on phage selection, resistance management and patient‐specific treatments will be crucial for the translation of PAS into clinical practice.
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spelling doaj-art-8975f5c917704e4bbff8282de4baaf7e2025-08-20T03:39:32ZengWileyHealth Science Reports2398-88352025-07-0187n/an/a10.1002/hsr2.70956Combined Forces Against Bacteria: Phages and AntibioticsShima Afrasiabi0Alireza Partoazar1Ramin Goudarzi2Ahmad Reza Dehpour3Laser Research Center of Dentistry, Dentistry Research Institute Tehran University of Medical Sciences Tehran IranExperimental Medicine Research Center Tehran University of Medical Sciences Tehran IranDivision of Research and Development Pharmin USA, LLC San Jose California USAExperimental Medicine Research Center Tehran University of Medical Sciences Tehran IranABSTRACT Background and Aim It is now known that bacteria are highly interactive and exhibit a range of complex cooperative behaviors, including conjugal plasmid transfer, toxins, swarming, drug resistance, toxin production, biofilm development, and other virulence traits. The development of phage–antibiotic synergy (PAS) could be a useful weapon against bacterial infections where antibiotics increase phage replication and antimicrobial activity. This study investigates the therapeutic potential of PAS in combating bacterial infections, focusing on the mechanisms and clinical implications. Methods A comprehensive review of recent literature was conducted analyzing studies on PAS, including their effects on biofilm degradation, multidrug‐resistant (MDR) bacteria, and toxin‐producing pathogens. Key factors such as timing, dosing and compatibility of phage‐antibiotic combinations were examined. Results PAS showed promising results in various bacterial infections. The combination of phages and antibiotics restored the susceptibility of MDR strains, facilitated the degradation of biofilms and minimized the need for high doses of antibiotics, thereby reducing potential side effects. However, challenges such as the emergence of resistance and antagonistic interactions with certain combinations remain. Key factors influencing the efficacy of PAS include phage and antibiotic dosing, timing of administration, and the physiological state of the bacteria. Conclusion PAS has potential applications in the treatment of complex infections. Despite the promising results, further research is essential to standardize protocols, optimize therapeutic combinations and address safety concerns. Clinical trials focusing on phage selection, resistance management and patient‐specific treatments will be crucial for the translation of PAS into clinical practice.https://doi.org/10.1002/hsr2.70956antibioticantimicrobial resistancebacteriophagebiofilmsMDRphage–antibiotic synergy
spellingShingle Shima Afrasiabi
Alireza Partoazar
Ramin Goudarzi
Ahmad Reza Dehpour
Combined Forces Against Bacteria: Phages and Antibiotics
Health Science Reports
antibiotic
antimicrobial resistance
bacteriophage
biofilms
MDR
phage–antibiotic synergy
title Combined Forces Against Bacteria: Phages and Antibiotics
title_full Combined Forces Against Bacteria: Phages and Antibiotics
title_fullStr Combined Forces Against Bacteria: Phages and Antibiotics
title_full_unstemmed Combined Forces Against Bacteria: Phages and Antibiotics
title_short Combined Forces Against Bacteria: Phages and Antibiotics
title_sort combined forces against bacteria phages and antibiotics
topic antibiotic
antimicrobial resistance
bacteriophage
biofilms
MDR
phage–antibiotic synergy
url https://doi.org/10.1002/hsr2.70956
work_keys_str_mv AT shimaafrasiabi combinedforcesagainstbacteriaphagesandantibiotics
AT alirezapartoazar combinedforcesagainstbacteriaphagesandantibiotics
AT ramingoudarzi combinedforcesagainstbacteriaphagesandantibiotics
AT ahmadrezadehpour combinedforcesagainstbacteriaphagesandantibiotics