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Primarily caused by uropathogenic\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      , the 400 million UTI cases annually are major global healthcare burdens and a primary cause of antibiotic prescriptions in the outpatient setting. Phage therapy has several potential advantages over antibiotics including the ability to disrupt bacterial biofilms and synergize with antimicrobial treatments with minimal side effects or impacts on the microbiota. Phage therapy for UTI treatment has shown generally favorable results in recent animal models and human case reports. Ongoing clinical trials seek to understand the efficacy of phage therapy in individuals with asymptomatic bacteriuria and uncomplicated cystitis. A possible challenge for phage therapy is the development of phage resistance in bacteria during treatment. While resistance frequently develops\n                      <jats:italic>in vitro<\/jats:italic>\n                      and\n                      <jats:italic>in vivo<\/jats:italic>\n                      , resistance can come with negative consequences for the bacteria, leaving them susceptible to antibiotics and other environmental conditions and reducing their overall virulence. \u201cSteering\u201d bacteria toward phage resistance outcomes that leave them less fit or virulent is especially useful in the context of UTI where poorly adherent or slow-growing bacteria are likely to be flushed from the system. In this article, we describe the history of phage therapy in treating UTI and its current resurgence, the state of its clinical use, and an outlook on how well-designed phage therapy could be used to \u201csteer\u201d bacteria toward less virulent and antimicrobial-susceptible states.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/ecosalplus.esp-0029-2023","type":"journal-article","created":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T09:04:33Z","timestamp":1704963873000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":18,"title":["The rise, fall, and resurgence of phage therapy for urinary tract infection"],"prefix":"10.1128","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3758-5503","authenticated-orcid":false,"given":"Jacob J.","family":"Zulk","sequence":"first","affiliation":[{"name":"Department of Molecular Virology and Microbiology, Baylor College of Medicine","place":["Houston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2631-8810","authenticated-orcid":true,"given":"Kathryn A.","family":"Patras","sequence":"additional","affiliation":[{"name":"Department of Molecular Virology and Microbiology, Baylor College of Medicine","place":["Houston, USA"]},{"name":"Alkek Center for Metagenomics and Microbiome Research, Baylor College of Medicine","place":["Houston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4452-3490","authenticated-orcid":false,"given":"Anthony W.","family":"Maresso","sequence":"additional","affiliation":[{"name":"Department of Molecular Virology and Microbiology, Baylor College of Medicine","place":["Houston, USA"]},{"name":"Department of Molecular Virology and Microbiology, Tailored Antibacterials and Innovative Laboratories for Phage (\u03a6) Research (TAIL\u03a6R), Baylor College of Medicine","place":["Houston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1086\/318850"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.888205"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro3432"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000152365.43125.3b"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0891-5520(03)00005-9"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9343(02)01055-0"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2013.09.003"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkt301"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.2105\/ajph.80.3.331"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-014-2569-5"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2003.08.005"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1024\/0040-5930.60.2.89"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00240-009-0176-6"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2010.32"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009071.pub2"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1086\/652861"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40779-021-00359-8"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.00926-19"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.3390\/v10070351"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.copbio.2020.11.004"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1128\/cmr.00062-22"},{"key":"e_1_3_2_23_2","first-page":"91","article-title":"Bacteriophage as a therapeutic agent in genito-urinary infections: part II","volume":"36","author":"Schultz EW","year":"1932","unstructured":"Schultz EW. 1932. 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