Abstract
Antibiotic resistance poses a significant global health threat, with multidrug-resistant bacteria such as MRSA, ESBL-producing E. coli, and carbapenem-resistant P. aeruginosa becoming increasingly prevalent. Phage therapy, which utilizes bacteriophages to target and lyse bacterial pathogens, has re-emerged as a promising alternative or adjunct to conventional antibiotics. This review explores the mechanisms of phage therapy, including the lytic cycle and enzymatic actions of endolysins and depolymerases, which enable phages to penetrate biofilms and sensitize bacteria to antibiotics. Key advantages of phage therapy include high specificity, minimal disruption to the microbiome, self-replication at infection sites, and low toxicity. Clinical case studies and trials demonstrate its efficacy in treating resistant infections, such as those in cystic fibrosis patients and chronic wounds. Challenges remain, including narrow host ranges, bacterial resistance, regulatory hurdles, and the need for standardized protocols. Innovations like CRISPR-engineered phages, phage-antibiotic synergy (PAS), and global phage banks offer potential solutions. Addressing research gaps such as large-scale randomized trials, long-term safety, and production scalability is critical for integrating phage therapy into mainstream medicine. Collaborative efforts among researchers, clinicians, and policymakers are essential to harness phage therapy's potential in combating the antibiotic resistance crisis.