- Research Article
- 10.1007/s40121-026-01320-9
Reimagining Phage Therapy for MDR Pathogens: From Biobanks to Health System Integration-A Review.
- Apr 01, 2026
- Infectious diseases and therapy
- Abay A Ayele + 5 more +5
Multidrug-resistant (MDR) pathogens, exemplified byKlebsiella pneumoniae, pose a critical and escalating threat in low- and middle-income countries (LMICs), where limited diagnostic and therapeutic options exacerbate mortality. Bacteriophage (phage) therapy has re-emerged as a promising alternative, offering high specificity, biofilm disruption, and potential for low-cost production. However, a significant translational gap persists; while in vitro studies and results personalized phage therapy demonstrate efficacy, the pathway to clinical integration, especially in LMICs, remains obstructed by systemic barriers including the lack of local phage banks and undefined regulatory pathways. This review moves beyond a summary of biological promise topropose a novel, structured framework for implementationtailored to resource-limited health systems. We synthesize current evidence to introduce the5-P roadmap, a cohesive strategy encompassing the establishment of integratedphage-host biobanks; development of context-appropriatepreparations; rigorouspreclinical validation emphasizing phage-antibiotic synergy; the parallel development ofpolicy and regulatory pathways; andpilot clinical trials designed for subsequent health system integration. By addressing these interconnected pillars simultaneously, this framework provides an actionable blueprint to advance phage therapy from a laboratory concept to a scalable, equitable, and sustainable adjunct within national antimicrobial resistance strategies in LMICs.
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