Phage-antibiotic synergy inhibited by temperate and chronic virus competition

TL;DR

This paper models how virus competition affects the effectiveness of combined phage and antibiotic treatments against bacterial infections, revealing that certain viral interactions can inhibit bacterial control and sometimes worsen infections.

Contribution

It introduces a model analyzing the impact of temperate and chronic virus competition on phage-antibiotic synergy, highlighting conditions where antibiotics may be less effective.

Findings

Temperate viruses can synergize with antibiotics to control bacteria.

Competition between temperate and chronic viruses can inhibit bacterial suppression.

Antibiotic resistance may lead to increased bacterial loads despite treatment.

Abstract

As antibiotic resistance grows more frequent for common bacterial infections, alternative treatment strategies such as phage therapy have become more widely studied in the medical field. While many studies have explored the efficacy of antibiotics, phage therapy, or synergistic combinations of phages and antibiotics, the impact of virus competition on the efficacy of antibiotic treatment has not yet been considered. Here, we model the synergy between antibiotics and two viral types, temperate and chronic, in controlling bacterial infections. We demonstrate that while combinations of antibiotic and temperate viruses exhibit synergy, competition between temperate and chronic viruses inhibits bacterial control with antibiotics. In fact, our model reveals that antibiotic treatment may counterintuitively increase the bacterial load when a large fraction of the bacteria develop antibiotic-resistance.