Table 1.

Topical phage therapy of infection.

Pathogen	Model	Outcome	Result of the therapy
Staphylococcus aureus	Early studies of the application of phage therapy in dermatology in 143 patients with purulent skin infections.	Phage application as direct injection into the wound and surrounding tissue.	The best results were observed in patients with acute infections of deep skin. In the studied group of patients successful treatment was observed in 75%, improvement in 7.7%, and no effect of the therapy was observed only in 4.9% of the treated patients (Beridze, 1938).
Staphylococcus	55 patients with furunculosis.	Oral and local phage administration.	In all cases good therapeutic results were obtained (Ślopek et al., 1987).
Staphylococcus, Pseudomonas, Klebsiella, Proteus, Escherichia	Studies concerned 31 patients with suppurative skin infections.	The treatment lasted 2–16 weeks.	During the treatment an improvement with suppression of local inflammation, faster healing of ulcers, and eradication of bacteria was observed. Good therapeutic effects were obtained in the case of 25 patients (16 with outstanding results, 7 with marked improvement, and 2 with transient improvement; Cisło et al., 1987).
Klebsiella pneumoniae B5055	Mouse model of burn wound infection.	A single dose of topical application of the Kpn5 phage suspended in 3% hydrogel (at MOI of 200) used as ointment.	Mice treated with only a single dose of phage showed a significant reduction in animals' mortality (66%) compared to the control group (Kumari et al., 2010).
Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii.	Animal models of diabetic cutaneous wound infection.	Topical administration in combination with wound debridement	A decrease in bacterial counts and improved wound healing in a rodent model of Staphylococcus aureus and Pseudomonas aeruginosa infections. The therapy was not as effective against Acinetobacter baumannii. Bacteriophage treatment may be effective in resolving chronic infections also when applied in combination with wound debridement (Mendes et al., 2013).
Staphylococcus, Streptococcus, P. aeruginosa	Patients with wounds/ulcers.	Local administration of PhagoBioDerm, which contains ciprofloxacin, α-chymotrypsin benzocaine, and bacteriophage based on biodegradable poly(ester amide)s matrix.	Resulted in healing in the case of 70% of patients. It was associated with elimination of and/or reduction in pathogenic bacteria in the ulcers. This slow-release biopolymer was safe and of possible benefit in the management of refractory wounds, and the apparent utility of bacteriophages was supported in this setting (Markoishvili et al., 2002).
	Prospective, randomized, double-blind, controlled phase I study for the safety and efficacy of treatment of venous leg ulcers was conducted by the Southwest Regional Wound Care Centre in Lubbock, Texas, USA (in 2006–2008).	Once a week for 12 weeks topical application of a cocktail of 8 lytic bacteriophages against P. aeruginosa, S. aureus, and E. coli. (named WPP-201), developed by Intralytix Inc., USA.	No safety concerns regarding bacteriophage treatment (Rhoads et al., 2009).
P. aeruginosa	Twenty-four patients suffering from otitis media caused by antibiotic refractory P. aeruginosa. A double-blind, placebo-controlled initial phase I/II clinical trial targeting chronic external ear infections (in 2006–2007).	Application of bacteriophage mixture (Biocontrol Ltd., UK)	The results of the treatment of half of them treated with a single dose of bacteriophage mixture confirmed that phage administration was safe. A significant reduction of clinical symptoms at day 42 in the bacteriophage treated group was observed (55% of total clinical score at day zero) compared to the control group (104%). It was accompanied by a 76% decrease in mean count of bacteria in samples taken from the patients' ears 6 weeks after phage application, whereas in controls a 9% increase was observed (Wright et al., 2009).
E. coli or P. aeruginosa	E. coli or P. aeruginosa burn wound infections. A phase I/II randomized multi-center clinical trial involving 11 different burn units located in France, Belgium and Switzerland. This four-arm study involves 220 patients.	Two topically applied therapeutic phage cocktails (PP0121 and PP1131)	Its primary endpoint is the time for reduction of the targeted bacterial load in wound burns with a specifically designed microbiological procedure (Gabard et al., 2015).