Antibiotic resistance has reached dangerously high levels throughout the world. A growing number of bacteria pose an urgent, serious, and concerning threat to public health. Few new antibiotics are available to clinicians and only few are in development, highlighting the need for new strategies to overcome the antibiotic resistance crisis. Combining existing antibiotics with phages, viruses the infect bacteria, is an attractive and promising alternative to standalone therapies. Phage–antibiotic combinations have been shown to suppress the emergence of resistance in bacteria, and sometimes even reverse it. Here, we discuss the mechanisms by which phage–antibiotic combinations reduce resistance evolution, and the potential limitations these mechanisms have in steering microbial resistance evolution in a desirable direction. We also emphasize the importance of gaining a better understanding of mechanisms behind physiological and evolutionary phage–antibiotic interactions in complex in-patient environments.

中文翻译：

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噬菌体-抗生素组合：一种抑制细菌耐药性进化的有前途的方法

抗生素耐药性在世界范围内已达到危险的高水平。越来越多的细菌对公众健康构成了紧迫、严重和令人担忧的威胁。可供临床医生使用的新抗生素很少，只有少数正在开发中，这凸显了克服抗生素耐药性危机的新策略的必要性。将现有抗生素与噬菌体、病毒感染细菌相结合，是一种有吸引力且有前景的独立疗法替代方案。噬菌体-抗生素组合已被证明可以抑制细菌耐药性的出现，有时甚至可以逆转它。在这里，我们讨论了噬菌体-抗生素组合减少耐药性进化的机制，以及这些机制在将微生物耐药性进化推向理想方向方面的潜在局限性。