ISSN: 0973-7510

E-ISSN: 2581-690X

Review Article | Open Access
Jamil Allen G. Fortaleza1,2 , Clarisse Kim C. Felisco3, Vishal Shete4, Jigme Wangchuk5, Jolo James Christian D. Rigby6, Arindam Mitra7 and Jose Jurel M. Nuevo8
1National University Philippines, Sampaloc, Manila, 1008, Philippines.
2Department of Biology, College of Science, De La Salle University, Manila, Philippines.
3School of Nursing and Allied Medical Sciences, Holy Angel University, Angeles City, Pampanga, Philippines.
4Department of Microbiology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India.
5National Centre for Biological Sciences, Bengaluru, Karnataka, India.
6School of Medical Laboratory Science, Far Eastern University- Dr. Nicanor Reyes Medical Foundation, Quezon City, Philippines.
7School of Allied and Healthcare Professions, RV University, Bengaluru, Karnataka, India.
8College of Medical Laboratory Sciences, Our Lady of Fatima University, Valenzuela, Philippines.
Article Number: 10757 | © The Author(s). 2025
J Pure Appl Microbiol. 2025;19(4):2415-2428. https://doi.org/10.22207/JPAM.19.4.42
Received: 09 July 2025 | Accepted: 10 November 2025 | Published online: 04 December 2025
Issue online: December 2025
Abstract

Pseudomonas aeruginosa is a leading cause of persistent and severe lung infections, especially in individuals with weakened immune systems and those suffering from conditions like cystic fibrosis or bronchiectasis. The pathogen’s resistance to antibiotics, driven by its ability to form biofilms, activate efflux pumps, and produce enzymes that break down drugs, has significantly limited the effectiveness of standard antimicrobial therapies. This review explores the increasing promise of bacteriophage therapy as both an alternative and a complementary approach for addressing multidrug-resistant (MDR) P. aeruginosa infections in the lungs. Phages, viruses that specifically target bacteria, offer strain-specific bactericidal activity, often bypassing mechanisms of antibiotic resistance. Recent studies demonstrate that phage monotherapy and phage-antibiotic combinations can effectively disrupt biofilms and enhance bacterial clearance, particularly when phage cocktails or targeted delivery systems are employed. Additionally, the review explores delivery routes for pulmonary infections and the formulation challenges that affect phage stability and bioavailability. Clinical cases and ongoing trials further underscore the feasibility and safety of phage therapy in real-world applications. However, hurdles such as phage immunogenicity, rapid clearance, and regulatory limitations must be addressed before widespread clinical implementation. Overall, phage therapy holds significant promise in overcoming the therapeutic stagnation posed by MDR P. aeruginosa, especially in chronic and nosocomial lung infections, and warrants continued research and clinical validation.

Keywords

Phage-antibiotic Combination, Antibiotic Resistance, Biofilm, Pseudomonas aeruginosa

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© The Author(s) 2025. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License which permits unrestricted use, sharing, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.