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The Safety and Efficacy of Phage Therapy for Bone and Joint Infections: A Systematic Review
Bacterial resistance to antibiotics has catalysed interest in alternative antimicrobial strategies. Bacteriophages (phages) are viruses of bacteria with a long history of successful therapeutic use. Phage therapy is a promising antibacterial strategy for infections with a biofilm component, includin...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7697170/ https://www.ncbi.nlm.nih.gov/pubmed/33182795 http://dx.doi.org/10.3390/antibiotics9110795 |
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author | Clarke, Alex L. De Soir, Steven Jones, Joshua D. |
author_facet | Clarke, Alex L. De Soir, Steven Jones, Joshua D. |
author_sort | Clarke, Alex L. |
collection | PubMed |
description | Bacterial resistance to antibiotics has catalysed interest in alternative antimicrobial strategies. Bacteriophages (phages) are viruses of bacteria with a long history of successful therapeutic use. Phage therapy is a promising antibacterial strategy for infections with a biofilm component, including recalcitrant bone and joint infections, which have significant social, financial and human impacts. Here, we report a systematic review of the safety and efficacy of phage therapy for the treatment of bone and joint infections. Three electronic databases were systematically searched for articles that reported primary data about human phage therapy for bone and joint infections. Two authors independently assessed study eligibility and performed data extraction. Seventeen reports were eligible for inclusion in this review, representing the treatment of 277 patients. A cautionary, crude, efficacy estimate revealed that 93.1% (n = 258/277) achieved clinical resolution, 3.3% (n = 9/277) had improvement and 3.6% (n = 10/277) showed no improvement. Seven of the nine reports that directly commented on the safety of phage therapy did not express safety concerns. The adverse effects reported in the remaining two were not severe and were linked to the presence of contaminating endotoxins and pre-existing liver pathology in a patient treated with high-titre intravenous phage therapy. Three other reports, from 1940–1987, offered general comments on the safety of phage therapy and documented adverse effects consistent with endotoxin co-administration concomitant with the use of raw phage lysates. Together, the reports identified by this review suggest that appropriately purified phages represent a safe and highly efficacious treatment option for complex and intractable bone and joint infections. |
format | Online Article Text |
id | pubmed-7697170 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-76971702020-11-29 The Safety and Efficacy of Phage Therapy for Bone and Joint Infections: A Systematic Review Clarke, Alex L. De Soir, Steven Jones, Joshua D. Antibiotics (Basel) Review Bacterial resistance to antibiotics has catalysed interest in alternative antimicrobial strategies. Bacteriophages (phages) are viruses of bacteria with a long history of successful therapeutic use. Phage therapy is a promising antibacterial strategy for infections with a biofilm component, including recalcitrant bone and joint infections, which have significant social, financial and human impacts. Here, we report a systematic review of the safety and efficacy of phage therapy for the treatment of bone and joint infections. Three electronic databases were systematically searched for articles that reported primary data about human phage therapy for bone and joint infections. Two authors independently assessed study eligibility and performed data extraction. Seventeen reports were eligible for inclusion in this review, representing the treatment of 277 patients. A cautionary, crude, efficacy estimate revealed that 93.1% (n = 258/277) achieved clinical resolution, 3.3% (n = 9/277) had improvement and 3.6% (n = 10/277) showed no improvement. Seven of the nine reports that directly commented on the safety of phage therapy did not express safety concerns. The adverse effects reported in the remaining two were not severe and were linked to the presence of contaminating endotoxins and pre-existing liver pathology in a patient treated with high-titre intravenous phage therapy. Three other reports, from 1940–1987, offered general comments on the safety of phage therapy and documented adverse effects consistent with endotoxin co-administration concomitant with the use of raw phage lysates. Together, the reports identified by this review suggest that appropriately purified phages represent a safe and highly efficacious treatment option for complex and intractable bone and joint infections. MDPI 2020-11-10 /pmc/articles/PMC7697170/ /pubmed/33182795 http://dx.doi.org/10.3390/antibiotics9110795 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Clarke, Alex L. De Soir, Steven Jones, Joshua D. The Safety and Efficacy of Phage Therapy for Bone and Joint Infections: A Systematic Review |
title | The Safety and Efficacy of Phage Therapy for Bone and Joint Infections: A Systematic Review |
title_full | The Safety and Efficacy of Phage Therapy for Bone and Joint Infections: A Systematic Review |
title_fullStr | The Safety and Efficacy of Phage Therapy for Bone and Joint Infections: A Systematic Review |
title_full_unstemmed | The Safety and Efficacy of Phage Therapy for Bone and Joint Infections: A Systematic Review |
title_short | The Safety and Efficacy of Phage Therapy for Bone and Joint Infections: A Systematic Review |
title_sort | safety and efficacy of phage therapy for bone and joint infections: a systematic review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7697170/ https://www.ncbi.nlm.nih.gov/pubmed/33182795 http://dx.doi.org/10.3390/antibiotics9110795 |
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