Fig. 5

Summary of therapeutic options to combat VRE in the clinical setting. a Potential types of therapeutic interventions based on the stage and location of VRE infection. Bacteriocins can be applied topically and encapsulated to reach the gut [149, 156, 169,170,171]. Phage therapy can be used, with a phage cocktail being preferential, in combination with continued bacterial monitoring [172,173,174,175]. Phage derived lytic proteins are a therapeutic option against VRE for oral, wound, gut and bloodstream infections [176, 177]. Evidence for the effectiveness of probiotics are found in references 198–194 [178,179,180,181,182,183,184]. b Biomedical applications of anti-VRE molecules, which can increase the specificity and half-life and broaden the application range. Advances in therapeutic delivery strategies can overcome limitations of stability and specificity through controlled release of effecter molecules and impregnation of medical devices or fibrous dressings for wound care [168, 176, 185, 186]. c Novel molecular mechanisms to remove AMR genes from the microbiota are being investigated, and a promising avenue is using CRISPR-Cas systems to target critical AMR genes in mixed microbial communities [187]