Bridging the gap between experimental evidence and clinical applications of antipseudomonal phage therapy against Pseudomonas aeruginosa

Pseudomonas aeruginosa is one of the World Health Organization's (WHO) priority pathogens requiring urgent intervention because of its remarkable ability to develop antimicrobial resistance. The rapid emergence and global dissemination of multidrug-resistant P. aeruginosa have made the treatment of these infections increasingly challenging, posing a major threat to public health worldwide. Consequently, there is an urgent need for alternative therapeutic strategies. Bacteriophage (phage) therapy has re-emerged as a promising antimicrobial approach for combating drug-resistant bacterial infections. Numerous in vitro, in vivo, and clinical studies have demonstrated the therapeutic potential of antipseudomonal phages, either as monotherapy or in combination with antibiotics. In this review, we comprehensively summarize the current evidence on antipseudomonal phage therapy, including laboratory investigations, animal studies, and personalized clinical applications. We further discuss the pharmacological and clinical considerations, major challenges limiting clinical translation, and the current knowledge gaps that hinder widespread implementation. Finally, we highlight key research priorities that should be addressed to facilitate the safe, effective, and evidence-based integration of bacteriophage therapy into routine clinical practice.