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. Author manuscript; available in PMC: 2023 Oct 21.
Published in final edited form as: Front Sci. 2023 Feb 28;1:997136. doi: 10.3389/fsci.2023.997136

FIGURE 3.

FIGURE 3

A renewed approach to phage therapy: phage selection against antibiotic resistance or virulence. Certain lytic phages may be more effective in phage therapy because they kill target bacteria while simultaneously imposing strong selection against bacterial antibiotic resistance or virulence when bacteria mutate to avoid phage attack. (A, B) Phages that use antibiotic efflux pumps as receptors (A) can select for phage-resistant bacterial mutants with impaired efflux pumps (B) that are more sensitive to antibiotics (72). (C, D) Phages that bind to structural virulence factors such as a capsular antigen (C) can select for phage-resistant non-capsulated bacterial mutants (D) (73) that are less virulent because they are more easily engulfed by host phagocytes (74).