# Bacterial meningitis in adults: therapeutic challenges in the era of antibiotic resistance and the potential of bacteriophages and associated by products

**Authors:** Magdalena Dzięgiel, Zuzanna Głodowicz, Aleksandra Jóźwiak, Weronika Roztkowska, Agnieszka Necel, Lidia Piechowicz

PMC · DOI: 10.3389/fcimb.2026.1755353 · Frontiers in Cellular and Infection Microbiology · 2026-02-06

## TL;DR

This paper discusses the challenges of treating bacterial meningitis due to antibiotic resistance and explores the potential of bacteriophages as an alternative therapy.

## Contribution

The paper highlights the limited clinical research on phage therapy for meningitis and emphasizes the need for comprehensive human trials.

## Key findings

- Antibiotic resistance is a major challenge in treating bacterial meningitis.
- Bacteriophage research shows promise in mouse models but lacks human clinical trials.
- Phage therapy could be a potential alternative to antibiotics but requires further validation.

## Abstract

Bacterial resistance to antibiotics is one of the leading factors encouraging the development of new therapeutic strategies. The increased resistance to antibiotics can be attributed to several factors, such as early and unnecessary administration, incorrect dosing, or incomplete antibiotic treatment. One of the diseases that calls for improved understanding of this problem is meningitis, which - if ineffectively treated - may result in severe neurological complications and death. This study provides an overview of the current antibiotic strategies for bacterial meningitis along with the therapeutic challenges associated with standard treatment options. In addition, it also presents the current progress in bacteriophage research, highlighting both their potential to replace some common antibiotic therapies in the treatment of meningitis and the significant lack of clinical studies regarding most of them. The research on phage therapy targeting meningitis-associated pathogens is limited, and where it exists, it is predominantly focused on mouse models. There, its efficiency seems mostly promising. Nevertheless, comprehensive clinical trials are needed to properly determine the efficacy and safety of phage therapy in humans before it becomes a significant alternative to antibiotics.

## Linked entities

- **Diseases:** bacterial meningitis (MONDO:0006670)
- **Species:** Mus musculus (taxon 10090)

## Full-text entities

- **Genes:** beta-lactamase [NCBI Gene 13915111]
- **Diseases:** N. meningitidis (MESH:C536108), urinary tract infection (MESH:D014552), aseptic meningitis (MESH:D008582), burn wound infection (MESH:D014946), epiglottitis (MESH:D004826), Leptospirosis (MESH:D007922), mycobacterial (MESH:C564468), Meningitis (MESH:D008580), CNS diseases (MESH:D002493), chronic kidney diseases (MESH:D051436), infected (MESH:D007239), XDR-TB (MESH:D054908), cardiovascular infections (MESH:D053821), cancers (MESH:D009369), diabetes (MESH:D003920), Klebsiella pneumoniae (MESH:D007710), bacteremia (MESH:D016470), death (MESH:D003643), immunodeficiency (MESH:D007153), catheter or implant infections (MESH:D055499), meningoencephalitis (MESH:D008590), IPD (MESH:D011008), altered consciousness (MESH:D003244), fracture (MESH:D050723), meningococcal disease (MESH:D008589), sinusitis (MESH:D012852), skin (MESH:D012871), MDR infections (MESH:D018088), alcoholics (MESH:D000437), liver diseases (MESH:D008107), Bacterial meningitis (MESH:D016920), headache (MESH:D006261), arthritis (MESH:D001168), inflammation (MESH:D007249), pneuomococcal disease (MESH:D004194), HAI (MESH:D003428), trauma (MESH:D014947), respiratory infections (MESH:D012141), Neisseria meningitidis (MESH:D006069), MRSA (MESH:D013203), middle ear infections (MESH:D010033), mastitis (MESH:D008413), neurological sequelae (MESH:D009422), bacterial infectious diseases (MESH:D003141), invasive (MESH:D009361), bloodstream infections (MESH:D018805), brucellosis (MESH:D002006), burn (MESH:D002056), listeriosis (MESH:D008088), penicillin allergy (MESH:D008586), CNS infections (MESH:D002494), TB (MESH:D014390), neurological deficits (MESH:D009461), Cutibacterium acnes infections (MESH:D000152), nuchal rigidity (MESH:D009127), fever (MESH:D005334), bone marrow aplasia (MESH:D019046), skin scarring (MESH:D002921), K. pneumoniae (MESH:D011014), allergy (MESH:D004342)
- **Chemicals:** quinolones (MESH:D015363), mycolic acid (MESH:D009171), agar (MESH:D000362), ciprofloxacin (MESH:D002939), ester (MESH:D004952), fluoroquinolones (MESH:D024841), rifampicin (MESH:D012293), lincosamides (MESH:D055231), tigecycline (MESH:D000078304), ceftaroline (MESH:C490727), linezolid (MESH:D000069349), epoxy (MESH:D004853), cephalosporin (MESH:D002511), ceftiofur sodium (MESH:C053503), sulfa drugs (MESH:D013449), macrolide (MESH:D018942), Ceftriaxone (MESH:D002443), oxazolidinones (MESH:D023303), aminoglycosides (MESH:D000617), salt (MESH:D012492), pyrazinamide (MESH:D011718), cefuroxime (MESH:D002444), stainless steel (MESH:D013193), isoniazid (MESH:D007538), Penicillin (MESH:D010406), fosfomycin (MESH:D005578), tetracycline (MESH:D013752), doxycycline (MESH:D004318), teicoplanin (MESH:D017334), ESBL (-), flucloxacillin (MESH:D005436), cefotaxime (MESH:D002439), P100 (MESH:D003565), erythromycin (MESH:D004917), Chloramphenicol (MESH:D002701), amoxicillin (MESH:D000658), Methicillin (MESH:D008712), Sb-1 (MESH:C047101), beta-lactam (MESH:D047090), moxifloxacin (MESH:D000077266), gentamicin (MESH:D005839), MSa (MESH:D015080), ceftazidime (MESH:D002442), carbapenems (MESH:D015780), Vancomycin (MESH:D014640), penicillin G (MESH:D010400), LPS (MESH:D008070), meropenem (MESH:D000077731), cefepime (MESH:D000077723), tetracyclines (MESH:D013754), cotrimoxazole (MESH:D015662), levofloxacin (MESH:D064704), cefazolin (MESH:D002437), daptomycin (MESH:D017576), water (MESH:D014867), ertapenem (MESH:D000077727), ampicillin-sulbactam (MESH:C035444), imipenem (MESH:D015378), ampicillin (MESH:D000667), clindamycin (MESH:D002981)
- **Species:** Klebsiella pneumoniae (species) [taxon 573], Listeria (genus) [taxon 1637], Haemophilus influenzae (species) [taxon 727], Fusobacterium necrophorum (species) [taxon 859], Twortvirus (genus) [taxon 1857846], Homo sapiens (human, species) [taxon 9606], Staphylococcus aureus (species) [taxon 1280], Bacteroides fragilis (species) [taxon 817], Rattus norvegicus (brown rat, species) [taxon 10116], Bacteria Latreille et al. 1825 (Bacteria stick insect, genus) [taxon 629395], Mus musculus (house mouse, species) [taxon 10090], Mycobacterium tuberculosis (species) [taxon 1773], Listeria monocytogenes (species) [taxon 1639], Malus domestica (apple, species) [taxon 3750], Neisseria meningitidis (species) [taxon 487], Cutibacterium acnes (species) [taxon 1747], Listeria innocua (species) [taxon 1642], Leptospira meyeri (species) [taxon 29508], Clostridium perfringens (species) [taxon 1502], Galleria mellonella (greater wax moth, species) [taxon 7137], Bacteriophage sp. (species) [taxon 38018], Gallus gallus (bantam, species) [taxon 9031], Leptospira (genus) [taxon 171], Streptococcus pneumoniae (species) [taxon 1313], Rubroshorea almon (species) [taxon 292004], Ovis aries (domestic sheep, species) [taxon 9940], Cavia porcellus (domestic guinea pig, species) [taxon 10141], Bos taurus (bovine, species) [taxon 9913], Pantoea sp. 100 (species) [taxon 586573], Oryctolagus cuniculus (domestic rabbit, species) [taxon 9986], Brucella abortus (species) [taxon 235], Brucella (genus) [taxon 234]
- **Cell lines:** /c — Mus musculus (Mouse), Hepatocellular carcinoma of the mouse, Cancer cell line (CVCL_9103), 23TH_48 — Homo sapiens (Human), Lung squamous cell carcinoma, Cancer cell line (CVCL_7026)

## Full text

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## References

199 references — full list in the complete paper: https://tomesphere.com/paper/PMC12920498/full.md

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Source: https://tomesphere.com/paper/PMC12920498