Bacteriophage Therapy as a Promising Substitute for Antibiotics: Current Advances, Clinical Applications, and Future Perspectives

Abstract

The rapid emergence and global dissemination of antimicrobial-resistant (AMR) bacteria have significantly reduced the effectiveness of conventional antibiotics, posing a major threat to modern healthcare. The increasing prevalence of multidrug-resistant pathogens, coupled with the slow development of new antimicrobial agents, has renewed interest in alternative therapeutic strategies. Among these, bacteriophage (phage) therapy has re-emerged as a promising biological approach due to its ability to selectively infect and eliminate bacterial pathogens while preserving the normal microbiota. Unlike broad- spectrum antibiotics, bacteriophages exhibit high host specificity, self-replicate at the site of infection, and can effectively disrupt bacterial biofilms, making them particularly attractive for treating chronic and drug-resistant infections. This review critically examines the biological characteristics of bacteriophages, their mechanisms of antibacterial action, therapeutic applications, advantages, and current limitations. Recent advances in phage engineering, genome editing, phage cocktails, encapsulation technologies, and combination therapies with antibiotics are also discussed, highlighting their potential to improve treatment efficacy and overcome bacterial resistance. Furthermore, the review evaluates findings from recent preclinical and clinical studies, regulatory challenges, manufacturing considerations, and safety issues that currently limit the widespread clinical implementation of phage therapy. Although several scientific and regulatory hurdles remain, accumulating experimental and clinical evidence indicates that bacteriophage therapy could become an important component of future antimicrobial strategies. Continued multidisciplinary research, standardized clinical protocols, and well-designed randomized clinical trials are essential to establish its long-term efficacy and safety. With ongoing advances in molecular biology, synthetic biology, and precision medicine, bacteriophage therapy has the potential to complement or, in selected clinical situations, replace conventional antibiotics in the management of multidrug-resistant bacterial infections.