Synergistic potential of probiotics and bacteriophages in combating multidrug-resistant microbial infections: A novel therapeutic strategy for the post-antibiotic era

Sadaf Ataei-Alamdari; Fatemeh Alimardani; Hamed Afkhami; Mojtaba Kashfi; Mohammad Hasan Yousefi

doi:10.1016/j.nmni.2026.101804

Synergistic potential of probiotics and bacteriophages in combating multidrug-resistant microbial infections: A novel therapeutic strategy for the post-antibiotic era

New Microbes New Infect. 2026 Jun 26:72:101804. doi: 10.1016/j.nmni.2026.101804. eCollection 2026 Aug.

Authors

Sadaf Ataei-Alamdari¹, Fatemeh Alimardani², Hamed Afkhami³, Mojtaba Kashfi⁴, Mohammad Hasan Yousefi^{3

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Affiliations

¹ Master of Medical Bacteriology, Department of Microbiology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran.
² Master of Medical Bacteriology, Department of Microbiology, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran.
³ Cellular and Molecular Research Center, Qom University of Medical Sciences, Qom, Iran.
⁴ Fellowship in Clinical Laboratory Sciences, Qom University of Medical Sciences, Qom, Iran.
⁵ Student Research Committee, Qom University of Medical Sciences, Qom, Iran.
⁶ Department of Tissue Engineering and Applied Cell Sciences, School of Medicine, Qom University of Medical Sciences, Qom, Iran.

Abstract

In recent years, the rapid emergence of multidrug-resistant (MDR) pathogens has posed a global health crisis, necessitating the exploration of alternative therapeutic strategies beyond conventional antibiotics. Among emerging solutions, the combination of probiotics and bacteriophages has gained significant attention due to their complementary mechanisms in targeting pathogenic bacteria while preserving host microbiota. This review comprehensively evaluates the molecular interactions, synergistic effects, safety profiles, and clinical applicability of probiotic-phage combinations in managing MDR infections. We also discuss challenges related to formulation, delivery, regulatory considerations, and future directions for translating this approach into clinical practice. The integration of probiotics and phage therapy represents a promising avenue to address antibiotic resistance, offering a personalized, targeted, and microbiome-friendly antimicrobial strategy.

Keywords: Antibiotic resistance; Bacteriophages; Combination therapy; MDR pathogens; Microbiome modulation; Phage therapy; Probiotics.

Publication types

Review