The increase in frequency of multidrug-resistant bacteria worldwide is largely the result of the massive use of antibiotics in the second half of the 20th century. These relatively recent changes in human societies revealed the great evolutionary capacities of bacteria towards drug resistance. In this article, we hypothesize that the success of future antibacterial strategies lies in taking into account both these evolutionary processes and the way human activities influence them. Faced with the increasing prevalence of multidrug-resistant bacteria and the scarcity of new antibacterial chemical molecules, the use of bacteriophages is considered as a complementary and/or alternative therapy. After presenting the evolutionary capacities of bacteriophages and bacteria, we show how the development model currently envisaged (based on the classification of bacteriophages as medicinal products similar to antibacterial chemical molecules) ignores the evolutionary processes inherent in bacteriophage therapy. This categorization imposes to bacteriophage therapy a specific conception of what a treatment and a therapeutic scheme should be as well as its mode of production and prescription. We argue that a new development model is needed that would allow the use of therapeutic bacteriophages fully adapted (after in vitro 'bacteriophage training') to the aetiologic bacteria and/or aimed at rendering bacteria either avirulent or antibiotic-susceptible ('bacteriophage steering'). To not repeat the mistakes made with antibiotics, we must now think about and learn from the ways in which the materialities of microbes (e.g. evolutionary capacities of both bacteriophages and bacteria) are intertwined with those of societies.

中文翻译：

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药物的进化生物学和开发模式：未来成功的噬菌体治疗的必要“双人舞”。

世界范围内多重耐药菌频率的增加主要是 20 世纪下半叶大量使用抗生素的结果。人类社会最近发生的这些变化揭示了细菌对耐药性的巨大进化能力。在本文中，我们假设未来抗菌策略的成功在于考虑到这些进化过程和人类活动对它们的影响方式。面对日益流行的多重耐药菌和新抗菌化学分子的稀缺性，噬菌体的使用被认为是一种补充和/或替代疗法。在展示了噬菌体和细菌的进化能力之后，我们展示了目前设想的开发模型（基于将噬菌体分类为类似于抗菌化学分子的医药产品）如何忽略噬菌体治疗固有的进化过程。这种分类对噬菌体疗法强加了一个特定的概念，即治疗和治疗方案应该是什么，以及它的生产和处方模式。我们认为需要一种新的开发模型，允许使用完全适应（在体外“噬菌体训练”之后）致病细菌和/或旨在使细菌无毒或对抗生素敏感（“噬菌体转向”）的治疗性噬菌体）。为了不重蹈抗生素的覆辙，