A review of phage therapy for drug-resistant Pseudomonas aeruginosa infections.

Pseudomonas aeruginosa is a major opportunistic pathogen implicated in a wide range of infections, including chronic respiratory infections, burn wound infections, urinary tract infections, and device-associated infections. Its intrinsic and acquired resistance mechanisms, particularly its capacity for biofilm formation, pose serious challenges to conventional antibiotic therapy. With the continued rise of multidrug-resistant and pan-drug-resistant strains, the need for alternative therapeutic strategies has become increasingly urgent. Phages, viruses that specifically recognize and lyse bacteria, have shown unique advantages in combating antibiotic-resistant infections. This review systematically summarizes recent advances in the application of phage therapy for P. aeruginosa infections, covering in vitro bactericidal activity, biofilm degradation, and synergistic interactions with antibiotics. We further discuss evidence from animal models, including therapeutic efficacy, immunomodulatory effects, and pharmacokinetics. Emphasis is placed on clinical use cases, including different routes of administration, symptom relief, biomarker modulation, pathogen clearance rates, and adverse events. Typical case reports and early-phase clinical trials support the safety and efficacy of phage therapy. Nevertheless, translational barriers persist, such as the need for precise host matching, risks of immune neutralization, and the lack of standardized regulatory frameworks and Good Manufacturing Practice (GMP)-grade production systems. The rapid development of engineered phages and individualized therapeutic approaches offers a feasible path forward. In conclusion, phage therapy holds significant promise for the treatment of drug-resistant P. aeruginosa infections, and future efforts should focus on establishing standardized systems, conducting multicenter clinical studies, and leveraging synthetic biology to accelerate its translation from bench to bedside.