Pairing antibiotics with phages: A new strategy to tackle biofilms of drug-resistant Acinetobacter baumannii-insights from in vitro and in vivo studies.

Emerging multidrug-resistant (MDR) and extensively drug-resistant (XDR) Acinetobacter baumanii is a serious challenge in hospital settings. Biofilm formation is one of these bacteria's most crucial mechanisms of antibiotic resistance. Given the ineffectiveness of common antibiotics against MDR, XDR, and biofilm-forming A. baumannii, the healthcare system must use new strategies to combat A. baumannii biofilm. This study aimed to provide an overview of the in vitro, in vivo, and ex vivo combination therapy of phages and antibiotics for combating A. baumanii biofilms. Most studies suggest that pairing antibiotics with phages could help break down A. baumannii biofilms and treat infections caused by these hard-to-beat superbugs, especially when using cocktail phages and colistin to inhibit biofilm formation or eradicate biofilms. Many limitations of phage therapy can be overcome by combining phage therapy with antibiotics. Additionally, protein-derived phages have been proposed as a promising alternative or complementary approach to conventional therapies, demonstrating significant antibacterial activity. When used in combination with antibiotics, they may enhance treatment efficacy by reducing the spread of antibiotic-resistant A. baumannii and effectively eliminating their biofilms. Combining antibiotics with phage therapy may offer an effective strategy to disrupt A. baumannii biofilms in laboratory settings and improve treatment outcomes for patients with drug-resistant infections.