Bacteriophages therapy as an Emerging Alternative for Multidrug-resistance klebsiella pneumonia

Multidrug-resistant (MDR) Klebsiella pneumoniae has become a major public health concern because of its ability to cause severe infections and resist multiple classes of antimicrobial agents. The emergence of extended-spectrum beta-lactamase-producing and carbapenem-resistant strains has significantly reduced the effectiveness of conventional antibiotic treatment. Bacteriophage therapy has gained attention as an alternative and complementary antimicrobial strategy because bacteriophages are viruses that specifically infect and destroy bacterial cells. Lytic bacteriophages can recognize bacterial surface receptors, introduce their genetic material, replicate inside susceptible bacteria, and cause bacterial cell lysis. In addition, certain phages produce depolymerase enzymes that degrade bacterial capsules and may help disrupt biofilms. Phage cocktails, personalized phage therapy, phage-derived enzymes, and phage–antibiotic combination therapy are important areas of current research. Preclinical investigations and selected clinical case reports have demonstrated promising results; however, therapeutic outcomes depend on bacterial susceptibility, phage characteristics, infection site, and treatment conditions. Important challenges include the narrow host range of individual phages, the development of phage resistance, immune responses, formulation difficulties, and limited controlled clinical evidence. This review discusses the biology, mechanisms, therapeutic applications, advantages, limitations, and future perspectives of bacteriophage therapy against MDR K. pneumoniae. Further clinical trials, standardized manufacturing procedures, and regulatory guidance are necessary to establish its safety and effectiveness in routine clinical practice.