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2018 ; 10
(6
): ä Nephropedia Template TP
Viruses
2018[Jun]; 10
(6
): ä PMID29895791
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Antibiotic resistance evolution in bacteria indicates that one of the challenges
faced by phage therapy is that, sooner or later, bacteria will evolve resistance
to phages. Evidently, this is the case of every known antimicrobial therapy, but
here this is also part of a ubiquitous natural process of co-evolution between
phages and bacteria. Fundamental evolutionary studies hold some clues that are
crucial to limit the problematic process of bacterial resistance during phage
applications. First, I discuss here the importance of defining evolutionary and
ecological factors influencing bacterial resistance and phage counter-defense
mechanisms. Then, I comment on the interest of determining the co-evolutionary
dynamics between phages and bacteria that may allow for selecting the conditions
that will increase the probability of therapeutic success. I go on to suggest the
varied strategies that may ensure the long-term success of phage therapy,
including analysis of internal phage parameters and personalized treatments. In
practical terms, these types of approaches will define evolutionary criteria
regarding how to develop, and when to apply, therapeutic phage cocktails.
Integrating this perspective in antimicrobial treatments, such as phage therapy,
is among the necessary steps to expand its use in the near future, and to ensure
its durability and success.
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