Considerations for Phage Therapy Against Mycobacterium abscessus.

Area of Science:

• Microbiology
• Infectious Diseases
• Bacteriophage Therapy

Background:

• Rising global incidence of *Mycobacterium abscessus* infections, particularly pulmonary infections.
• Limited therapeutic options due to high intrinsic and acquired antibiotic resistance.
• Opportunistic nature of *M. abscessus* exacerbates treatment challenges.

Purpose of the Study:

• To review current recommendations for future phage therapy administrations.
• To explore strategies for enhancing phage efficacy against *M. abscessus*.
• To highlight the potential of phage therapy in managing *M. abscessus* infections, including in cystic fibrosis patients.

Main Methods:

• Review of existing literature and case reports on phage therapy for *M. abscessus*.
• Analysis of strategies for phage discovery and application.
• Discussion of combined phage-antibiotic approaches and novel delivery systems.

Main Results:

• Successful compassionate use of mycobacteriophages combined with antibiotics in a patient with *M. abscessus* infection.
• Identification of strategies to broaden phage specificity and overcome bacterial resistance.
• Demonstration of potential synergistic effects between phages and antibiotics.

Conclusions:

• Phage therapy presents a promising alternative and adjunct treatment for *Mycobacterium abscessus* infections.
• Future directions include phage cocktails, combined therapies, and advanced delivery methods.
• Phage therapy may offer unique benefits for cystic fibrosis patients, including immunomodulatory effects and biofilm disruption.