Application of Phage Therapy in Antibiotic-Resistant Bacterial Infections

A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 8923

Special Issue Editors


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Guest Editor
FixedPhage Ltd., Glasgow G20 0SP, UK
Interests: bacteriophage application

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Guest Editor
Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium
Interests: bacteriophage; phage therapy
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Special Issue Information

Dear Colleagues,

The rise in antimicrobial resistance (AMR), combined with a dwindling pipeline of new antimicrobials has led to an increasing drive to find ways to supplement our current and future antimicrobial arsenal.  This push has led to a renewed interest in the therapeutic use of bacteriophages (viruses which kill bacteria).  The recent interest in phages has been driven by several factors, for example, phages can be used alone or in combination with other antibiotics to treat resistant infections; phages can effectively degrade biofilms; and phages are less disruptive to healthy microbiomes.

This special issue is collating primary research and review papers on the use of phages as alternatives/adjuncts to antibiotics, and in applications where phages could reduce antibiotic use.  While we welcome any relevant phage papers, there is a specific focus on areas affecting the application of phages as therapeutics:

i) The use of phages in combination with antibiotics and synergism between the two.

ii) The development and use of phages in “compassionate use” cases in humans/animals.

iii) The application of phages to biofilms.

iv) The use of phages to specifically remove unwanted bacteria, while leaving the beneficial commensals intact.

Dr. Jason Clark
Dr. Jean-Paul Pirnay
Guest Editors

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Published Papers (2 papers)

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Review

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13 pages, 508 KiB  
Review
The Safety and Efficacy of Phage Therapy: A Systematic Review of Clinical and Safety Trials
by Helen J. Stacey, Steven De Soir and Joshua D. Jones
Antibiotics 2022, 11(10), 1340; https://doi.org/10.3390/antibiotics11101340 - 30 Sep 2022
Cited by 41 | Viewed by 6347
Abstract
Trials of phage therapy have not consistently reported efficacy. This contrasts with promising efficacy rates from a sizeable and compelling body of observational literature. This systematic review explores the reasons why many phage trials have not demonstrated efficacy. Four electronic databases were systematically [...] Read more.
Trials of phage therapy have not consistently reported efficacy. This contrasts with promising efficacy rates from a sizeable and compelling body of observational literature. This systematic review explores the reasons why many phage trials have not demonstrated efficacy. Four electronic databases were systematically searched for safety and/or efficacy trials of phage therapy. Sixteen trials of phage therapy were included, in which 378 patients received phage. These were divided into historical (pre-2000; N = 3; n = 76) and modern (post-2000; N = 13; n = 302) trials. All 13 modern trials concluded that phage therapy was safe. Six of the 13 modern trials were exclusively safety trials. Seven modern trials investigated both safety and efficacy; efficacy was observed in two. Two of three historical trials did not comment on safety, while adverse effects in the third likely reflected the use of phage preparations contaminated with bacterial debris. None of the historical trials contained evidence of efficacy. The evidence from trials is that phage therapy is safe. For efficacy to be observed a therapeutic amount of the right phage(s) must be delivered to the right place to treat infections containing enough susceptible bacterial cells. Trials that have not demonstrated efficacy have not fulfilled one or more elements of this principle. Full article
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8 pages, 220 KiB  
Perspective
Managing Patient and Clinician Expectations of Phage Therapy in the United Kingdom
by Joshua D. Jones, Helen J. Stacey, Arlene Brailey, Mehrunisha Suleman and Ross J. Langley
Antibiotics 2023, 12(3), 502; https://doi.org/10.3390/antibiotics12030502 - 2 Mar 2023
Cited by 5 | Viewed by 2032
Abstract
Bacteriophage (phage) therapy is a promising alternative antimicrobial approach which has the potential to transform the way we treat bacterial infections. Phage therapy is currently being used on a compassionate basis in multiple countries. Therefore, if a patient has an antibiotic refractory infection, [...] Read more.
Bacteriophage (phage) therapy is a promising alternative antimicrobial approach which has the potential to transform the way we treat bacterial infections. Phage therapy is currently being used on a compassionate basis in multiple countries. Therefore, if a patient has an antibiotic refractory infection, they may expect their clinician to consider and access phage therapy with the hope of improvement. The expectations of clinicians may be similar and may also include expectations around data collection. However, there are multiple biological and practical barriers to fulfilling patient and clinician expectations. While it is possible to access phage therapy, the path to acquisition is not straightforward and expectations therefore need to be managed appropriately to avoid raising false hope and undermining confidence in phage therapy. Phage scientists have an important contribution to make in educating clinicians and the broader public about phage therapy. However, it is clinicians that are responsible for managing the expectations of their patients and this relies on clear communication about the barriers and limitations. Full article
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