Potential of Nitric Oxide and Bacteriophages as Combined Antibacterial Agents to Counter Drug-Resistant Infections

The ongoing threat of antimicrobial-resistant (AMR) bacteria and the growing population of AMR bacteria have inspired research into alternative antimicrobial agents. Previous studies have shown clinically relevant bactericidal effects of the molecule nitric oxide (NO). Not only has extensive research proven its antimicrobial effect, but bacteria have also been shown to be less likely to become resistant to NO. Numerous studies have also demonstrated that NO is compatible with commercially available antibiotic drugs, enhancing antimicrobial effects. However, these drugs are not always readily available or easily manufactured. This study proposes combining NO with naturally sourced antibacterial agents, namely bacteriophages. This combination of NO with bacteriophages in solution demonstrated an 82 ± 1.7% killing efficiency against its target pathogen, Escherichia coli, and a 74 ± 2.9% reduction in Methicillin-resistant Staphylococcus aureus throughout a 12 h growth curve, indicating significant potential for further development as a broad-spectrum antimicrobial combination therapy.