Interesting and potentially dangerous. But as long as many millions of pigs are covered in antibiotic foam (which is just rinsed off into the drain), I'm not gonna lie sleepless over this. Resistant bacteria will cause humanity huge troubles if we don't manage to do something radical soon.
The answer is phages. But last time I went into the rabbit hole the TLDR was that it is not patentable so there's no money in it. And everyone needs a different phages cocktail. I sleep at night knowing that push come to shove someone will step in and mass produce machines to create personal phage cocktails.
Phages do work, and we've treated a small bunch of people at Phage Australia for our clinical trial.
There's a few things about using phages for treatments I think everyone should be aware of:
(1) phages work!! The physicians we work with (and ourselves) are surprised every time they work. It's just really labor and time-intensive.
(2) if antibiotics are "bite sized snacks" then phages are like "getting a personalized chef - a course of phages should be highly personalized to the pathogens causing trouble, and sometimes the antibiotics. Too generic and it won't work. Too personalized and it's too expensive. Tricky balance. We're collecting data and trying to figure out what that balance is. Every patient is very different though and it's hard to draw conclusions and see patterns.
(3) at Phage Australia we're not doing the cocktail approach — we're (trying to) assembling a library of phages that should be able to cover lots of common pathogens and local outbreaks. We work with antibiotic resistance reference labs and hopefully eventually get enough coverage, by building a library of phages that we can mix and match before we get an inquiry. The TGA is onboard with this. (The FDA is looking into this tentatively; look up Adaptive Phage Therapeutics). The kind of phage therapy we're looking at is closer to CAR T-cell therapy, FMT and other kinds of individual / personalized therapies.
tl;dr: Phages work, but getting them and getting/paying for them is more like a service and less like a pill. It's also very expensive and hard to do today. We to work with regulators to push more personalized therapies. The age of generic pills in a bottle is slowly fading away.
(Source: I'm the "computer person" aka research software engineer on the Phage Australia clinical trial)