Phage- and enzybiotic-coated urinary catheters to prevent recurrent multidrug-resistant bacterial infections.

Introduction: Catheter-associated urinary tract infections (CAUTIs) are among the most prevalent hospital-acquired infections, posing a serious clinical and economic burden, particularly in the context of rising antibiotic resistance. Biofilm formation on indwelling catheters by multidrug-resistant uropathogens further complicates treatment and prevention, underscoring the urgent need for alternative, non-antibiotic solutions.

Areas covered: This article explores the potential of bacteriophage- and enzybiotic-coated urinary catheters as an innovative strategy to prevent recurrent bacterial infections. We review the clinical significance of biofilm formation on the surface of urinary catheters, the role of phages and their lytic enzymes in disrupting biofilms, and the clinical evidence supporting the efficacy of phage therapy. The reference list was compiled through a structured search of peer-reviewed studies and case reports, particularly from recent years, available in the PubMed database.

Expert opinion: Phage- and enzybiotic-functionalized catheters represent a promising non-antibiotic approach to CAUTI prevention. These biological agents offer targeted antibacterial activity, disrupt biofilms, and reduce the risk of drug resistance development. Their integration into catheter design may significantly improve infection control, reduce antibiotic use, and align with global antimicrobial stewardship goals. However, clinical standardization and regulatory clarity are crucial for advancing their implementation in routine clinical practice.