TABLE 4.

Anti-biofilm combination therapy studies.

Author, year	Biofilm-forming bacteria	Phage strain	Growth site	Results
Chen et al., 2021	A. baumannii	vB_AbaM-IME-AB2	96-well plate	Total eradication of human serum bacteria at 50% volume ratio when combination of phage and colistin was applied.
Doub et al., 2021	S. epidermidis	PM448	Bacterial site in the intraarticular space of the patient’s prosthetic knee	Combination therapy of phage and debridement, antibiotics, irrigation, and retention of the prosthesis surgery led the patient to recover from recalcitrant prosthetic joint infection by having thorough eradication of biofilm biomass.
Latka and Drulis-Kawa, 2020	K. pneumoniae	KP34	96 well plates	Best antibiofilm results where lytic phage KP34 was applied in combination with ciprofloxacin
Kifelew et al., 2020	S. aureus	AB-SA01	96-well polystyrene tissue culture plate	Application of phage cocktails led to a significant reduction in bacterial host population within mixed-species biofilm, while combination with tetracycline led to more bacterial population reduction.
Henriksen et al., 2019	P. aeruginosa	ATCC 12175-B1, ATCC 14203-B1, ATCC 14205-B1	Flow cells	Single phage treatment led to an 85% to 95% reduction in biofilm’s biovolume.
				Repeated phage treatment enhanced the biovolume of the biofilm after the second and third treatments.
				The combination of phages and ciprofloxacin led to biomass reduction of 6 log units.
				Demonstrated the possibility of bacterial resistance to phages and the effectiveness of combination therapy of phages and antibiotics.
Papadopoulou et al., 2019	Flavobacterium psychrophilum (F. psychrophilum)	Fpv-9, Fpv-10	96-well polystyrene microtitre plates	Phage cocktail led to a significant reduction in biofilm biomass after 24-hour exposure
				Anti-biofilm compounds (2-aminoimidazole, emodin, parthenolide, and D-leucine) inhibited biofilm formation for up to 80%.
				Suggesting the higher efficacy of combinational therapy of phage and inhibiting compounds against biofilm.
Chhibber et al., 2015	K. pneumoniae, P. aeruginosa	KP01K2, Pa29	Black polycarbonate membrane, 96-well microtiter plates with TSB medium	Led to log-CFU/cm2 biofilm reduction of 3.9 when using KP01K2 for Klebsiella, while no significant reduction was observed when using Pa29 for Pseudomonas.
				Led to log-CFU/cm2 biofilm reduction of 2.8 when both phages were used.
				Led to complete eradication or log-CFU/cm2 biofilm reduction of 4 when combinational use of KP01K2 and xylitol was used for Klebsiella or Pseudomonas, respectively.
				Led to log-CFU/cm2 biofilm reduction of 6 when combinational use of KP01K2, Pa29. and xylitol was used for Pseudomonas.
				Suggesting the higher efficacy of combinational therapy of phage and xylitol against biofilm
Seth et al., 2013	S. aureus	Bacteria-specific phages	Six-millimeter dermal punch wounds in New Zealand rabbit ears	The combination of phage therapy and sharp debridement decreased bacterial biofilm cell counts by a 2-log fold (99% removal).
				Illustrated the effective approach of combining phage therapy and sharp debridement technique.