Viruses 2026, 18(5), 534; https://doi.org/10.3390/v18050534 - 1 May 2026
Abstract
Rising antimicrobial resistance has revived global interest in phage therapy, yet its transition to standard clinical practice remains slow. This challenge is not solely due to a lack of efficacy. Instead, we face a fundamental conceptual barrier caused by an “evaluation mismatch.” Traditional
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Rising antimicrobial resistance has revived global interest in phage therapy, yet its transition to standard clinical practice remains slow. This challenge is not solely due to a lack of efficacy. Instead, we face a fundamental conceptual barrier caused by an “evaluation mismatch.” Traditional regulations treat phages as static chemical molecules—like taking a “snapshot.” However, biologically, phages are dynamic, evolving populations—more like a living “movie.” In this review, we use Schrödinger’s cat metaphor to explain this reality: phage variability is not a defect, but an essential feature. To bridge this gap, we propose a Controlled Evolutionary Platform. By distinguishing between a fixed “Safety Core” and a fluctuating “Adaptive Periphery,” we can manage viral evolution rather than trying to stop it. Ultimately, to integrate phages into modern medicine, we must redefine “consistency”: shifting our focus from preserving a fixed genetic sequence to ensuring the reliable performance of population dynamics.
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