Personalized bacteriophage therapy selects, adapts, or engineers a phage preparation against a patient clinical isolate. This biological specificity may improve target engagement but complicates standardization and causal inference.

To evaluate human clinical evidence on personalized or strain-matched phage therapy and distinguish direct personalized evidence from indirect randomized evidence generated with fixed phage preparations.

The review was structured according to PRISMA 2020. Seven bibliographic and trial sources plus citation searches were assessed through 8 July 2026.

Thirteen reports representing 10 study datasets were included. Personalized series showed repeated clinical and microbiological signals, but effectiveness certainty remained very low.

The most defensible clinical model is adjunctive precision infectious-disease care combining a matched, quality-controlled phage preparation with optimized antibacterial therapy, source control, and longitudinal monitoring.