Progress and Pitfalls of Bacteriophage Therapy in Critical Care: A Concise Definitive Review.

Valente, Luca; Prazak, Josef; Que, Yok-Ai; Cameron, David R. (2021). Progress and Pitfalls of Bacteriophage Therapy in Critical Care: A Concise Definitive Review. Critical care explorations, 3(3), e0351. Wolters Kluwer Health 10.1097/CCE.0000000000000351

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Objective

Bacterial infections caused by antibiotic-resistant pathogens are a major problem for patients requiring critical care. An approach to combat resistance is the use of bacterial viruses known as "phage therapy." This review provides a brief "clinicians guide" to phage biology and discusses recent applications in the context of common infections encountered in ICUs.

Data Sources

Research articles were sourced from PubMed using search term combinations of "bacteriophages" or "phage therapy" with either "lung," "pneumonia," "bloodstream," "abdominal," "urinary tract," or "burn wound."

Study Selection

Preclinical trials using animal models, case studies detailing compassionate use of phage therapy in humans, and randomized controlled trials were included.

Data Extraction

We systematically extracted: 1) the infection setting, 2) the causative bacterial pathogen and its antibiotic resistance profile, 3) the nature of the phage therapeutic and how it was administered, 4) outcomes of the therapy, and 5) adverse events.

Data Synthesis

Phage therapy for the treatment of experimental infections in animal models and in cases of compassionate use in humans has been associated with largely positive outcomes. These findings, however, have failed to translate into positive patient outcomes in the limited number of randomized controlled trails that have been performed to date.

Conclusions

Widespread clinical implementation of phage therapy depends on success in randomized controlled trials. Additional translational and reverse translational studies aimed at overcoming phage resistance, exploiting phage-antibiotic synergies, and optimizing phage administration will likely improve the design and outcome of future trials.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Valente, Luca Gabriele; Prazak, Josef; Que, Yok-Ai and Cameron, David Robert

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

2639-8028

Publisher:

Wolters Kluwer Health

Language:

English

Submitter:

Jsabelle Arni

Date Deposited:

08 Jun 2021 11:55

Last Modified:

13 Jun 2021 03:09

Publisher DOI:

10.1097/CCE.0000000000000351

PubMed ID:

33786430

Uncontrolled Keywords:

antibiotic resistance nosocomial infections phage therapy

BORIS DOI:

10.48350/156435

URI:

https://boris.unibe.ch/id/eprint/156435

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