# Beyond Antibiotics: Therapeutic Strategies Utilizing Probiotics and Bacteriophages Against Drug-Resistant Staphylococcus aureus

**Authors:** Miao Zhao, Dongli Rong, Ling Chen, Shuzhen Cai, Yongcheng Lu, Jingsha Dai, Youxiong Zhang, Xianhu Wei, Xiaojuan Yang, Qingping Wu

PMC · DOI: 10.3390/microorganisms14020344 · Microorganisms · 2026-02-02

## TL;DR

This review explores how combining probiotics and bacteriophages could offer new ways to treat drug-resistant Staphylococcus aureus infections.

## Contribution

The paper provides a systematic comparison of phage and probiotic therapies for S. aureus, highlighting their synergistic potential.

## Key findings

- Phage and probiotic therapies each have distinct mechanisms and clinical efficacies against drug-resistant S. aureus.
- Combining phages and probiotics may overcome limitations and enhance antibacterial effectiveness.
- The review identifies industrial and translational challenges for both approaches.

## Abstract

Staphylococcus aureus, as a critical zoonotic and foodborne pathogen, not only triggers public health threats such as food poisoning but also acts as a leading cause of diverse clinical infections, including skin infections, pneumonia, and endocarditis. Confronted with the growing crisis of multidrug resistance in S. aureus, both phage therapy and probiotic therapy have emerged as promising alternative biological strategies; however, the current literature predominantly examines them in isolation. This review therefore aims to delineate the contemporary therapeutic challenges of drug-resistant S. aureus and to systematically compare the mechanisms and clinical translation of phages and probiotics within an integrated analytical framework. We first outline the current therapy landscape, then present side by side the molecular inhibitory mechanisms and clinical progress of both approaches, followed by a comparative analysis of their antibacterial mechanisms, clinical efficacy, and industrial challenges. Through this consolidated perspective, the review not only clarifies the distinct strengths and limitations of each strategy but also seeks to provide researchers and clinicians with a comprehensive mechanistic and evidence-based reference for developing novel antibacterial technologies and designing innovative therapeutic regimens. Ultimately, it highlights potential synergies between phages and probiotics, offering a forward-looking roadmap to overcome S. aureus resistance and advance personalized combinatorial therapies.

## Linked entities

- **Diseases:** pneumonia (MONDO:0005249), endocarditis (MONDO:0005025)
- **Species:** Staphylococcus aureus (taxon 1280)

## Full-text entities

- **Genes:** catalase [NCBI Gene 28381092], adenylosuccinate lyase [NCBI Gene 28380445], alpha-hemolysin [NCBI Gene 28381283], ETB [NCBI Gene 17374496], QacA [NCBI Gene 9487077]
- **Diseases:** Device Infections (MESH:D009471), SSSS (MESH:D013206), toxic shock syndrome (MESH:D012772), infectious diseases (MESH:D003141), bloodstream infection (MESH:D018805), S. aureus Infections (MESH:D013203), skin and soft tissue (MESH:D017695), endocarditis (MESH:D004696), cellulitis (MESH:D002481), Vaginitis (MESH:D014627), osteomyelitis (MESH:D010019), Bacteremia (MESH:D016470), MRSA prosthetic joint infection (MESH:D007239), necrotizing pneumonia (MESH:D000071067), ulcer (MESH:D014456), vulvovaginal candidiasis (MESH:D002181), UTIs (MESH:D014552), toxicity (MESH:D064420), Wound Infection (MESH:D014946), ototoxicity (MESH:D006311), bullous impetigo (MESH:D007169), diabetic foot osteomyelitis (MESH:D017719), conjunctivitis (MESH:D003231), deaths (MESH:D003643), food poisoning (MESH:D005517), fever (MESH:D005334), Immune suppression (OMIM:146850), hypotension (MESH:D007022), mastitis (MESH:D008413), multiple organ failure (MESH:D009102), Pneumonia (MESH:D011014), folliculitis (MESH:D005499), MRSA (MESH:D060467), diabetic (MESH:D003920), critically ill (MESH:D016638), abscesses (MESH:D000038), Inflammatory (MESH:D007249), SSTIs (MESH:D018461), pulmonary infection (MESH:D012141), injury to (MESH:D014947), skin (MESH:D012871), bacterial vaginosis (MESH:D016585)
- **Chemicals:** beta-lactam (MESH:D047090), Sb-1 (MESH:C047101), short-chain fatty acids (MESH:D005232), fucose (MESH:D005643), povidone-iodine (MESH:D011206), Lipopeptides (MESH:D055666), daptomycin (MESH:D017576), SMX/TMP (MESH:D015662), lipopolysaccharide (MESH:D008070), linezolid (MESH:D000069349), enterocins (MESH:C012306), fluoroquinolones (MESH:D024841), H2O2 (MESH:D006861), Biosurfactants (-), K+ (MESH:D011188), acetic acid (MESH:D019342), teichoic acids (MESH:D013682), methicillin (MESH:D008712), phenol (MESH:D019800), propionic acid (MESH:C029658), lipid II (MESH:C069249), Iron (MESH:D007501), Vancomycin (MESH:D014640), nitrogen (MESH:D009584), lactic acid (MESH:D019344), Polysaccharide (MESH:D011134), lipoteichoic acids (MESH:C009900), Carbon (MESH:D002244), doxycycline (MESH:D004318), fengycin (MESH:C049972), acids (MESH:D000143)
- **Species:** Bacteriophage sp. (species) [taxon 38018], Lactiplantibacillus plantarum (species) [taxon 1590], Capra hircus (domestic goat, species) [taxon 9925], Bos taurus (bovine, species) [taxon 9913], Lactobacillus sp. L8 (species) [taxon 132302], Bacteria Latreille et al. 1825 (Bacteria stick insect, genus) [taxon 629395], Leptospira sp. AB (species) [taxon 103236], Staphylococcus aureus (species) [taxon 1280], Rattus norvegicus (brown rat, species) [taxon 10116], Homo sapiens (human, species) [taxon 9606], Bifidobacterium (genus) [taxon 1678], Enterococcus (genus) [taxon 1350], Streptococcus salivarius K12 (strain) [taxon 1200793], aureus [taxon 46170], Ovis aries (domestic sheep, species) [taxon 9940], Mus musculus (house mouse, species) [taxon 10090], Bacillus subtilis (species) [taxon 1423]

## Full text

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## References

177 references — full list in the complete paper: https://tomesphere.com/paper/PMC12943351/full.md

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Source: https://tomesphere.com/paper/PMC12943351