Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Clarke, Alex L., De Soir, Steven, Jones, Joshua D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
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
_version_ 1783615559243399168
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
work_keys_str_mv AT clarkealexl thesafetyandefficacyofphagetherapyforboneandjointinfectionsasystematicreview
AT desoirsteven thesafetyandefficacyofphagetherapyforboneandjointinfectionsasystematicreview
AT jonesjoshuad thesafetyandefficacyofphagetherapyforboneandjointinfectionsasystematicreview
AT clarkealexl safetyandefficacyofphagetherapyforboneandjointinfectionsasystematicreview
AT desoirsteven safetyandefficacyofphagetherapyforboneandjointinfectionsasystematicreview
AT jonesjoshuad safetyandefficacyofphagetherapyforboneandjointinfectionsasystematicreview