RT Journal Article SR Electronic T1 The selection of antibiotic- and bacteriophage-resistant Pseudomonas aeruginosa is prevented by their combination JF bioRxiv FD Cold Spring Harbor Laboratory SP 2022.05.25.493369 DO 10.1101/2022.05.25.493369 A1 Aude A Ferran A1 Marlène Z. Lacroix A1 Ophélie Gourbeyre A1 Alicia Huesca A1 Baptiste Gaborieau A1 Laurent Debarbieux A1 Alain Bousquet-Mélou YR 2022 UL http://biorxiv.org/content/early/2022/05/25/2022.05.25.493369.abstract AB Objectives Bacteria developing resistance compromise the efficacy of antibiotics or bacteriophages (phages). We tested the association of these two antibacterials to circumvent resistance.Methods With the Hollow Fiber Infection Model (HFIM), we mimicked the concentration profile of ciprofloxacin in the lungs of patients treated orally for Pseudomonas aeruginosa infections and independently, mimicked a single inhaled administration of phages (one or two phages).Results Each treatment selects for antibiotic-or phage-resistant clones in less than 30 h. By contrast, no bacteria were recovered from the HFIM at 72 h when ciprofloxacin was started 4 h post-phage administration, even when increasing the initial bacterial concentration by a 1000 fold.Conclusion The combination of phages with antibiotics used according to clinical regimens prevents the growth of resistant clones, providing opportunities to downscale the use of multiple antibiotics.Competing Interest StatementThe authors have declared no competing interest.