Antibiotic class shapes O-antigen-dependent phage outcomes in a clinical Pseudomonas aeruginosa isolate.

In a clinical Pseudomonas aeruginosa isolate (ZS-PA-35), phipa10 outcomes depend on antibiotic class, with meropenem driving large galU/hmgA deletions and the highest larval survival.

• Why it matters: Phage–antibiotic combinations are being explored against multidrug resistance, but it is unclear whether antibiotic choice changes bacterial suppression, phage replication, and resistance phenotypes in the same system.
• What they did: The study tested O-antigen-dependent phipa10 with amikacin, levofloxacin, or meropenem against ZS-PA-35, measuring growth and extracellular infectious phage yield at 24 h and sequencing phage-resistant mutants.
• The result: High amikacin and meropenem reduced extracellular phipa10 yield, and levofloxacin at the highest concentration also lowered recovered phage yield; in Galleria mellonella, phipa10–antibiotic combinations improved survival versus either treatment alone, with meropenem showing the highest observed survival proportion despite reduced in vitro phage yield.

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