Table 1.

Patient characteristics.

	Patient 1	Patient 2	Patient 3	Patient 4
Relevant medical history	2013—Solitary fibrous tumor in left pelvic region. Treated with neoadjuvant radiotherapy and surgical resection; reconstruction with bone grafts, osteosynthesis and free muscle flap.	2017—Polytrauma after assault, with open segmental fractures of the right femur. Treated with debridements, staged open reductions, proximal and distal fracture fixation of the femur and synthetic bone grafting. Soft tissue coverage with a lateral Gastrocnemius flap.	1995—Polytrauma after building collapse, with crush lesions of the right upper leg, complex femur fractures, condylar fracture of the knee and compartment syndrome. Treated with plate fixation.	1981—Polytrauma after traffic accident, with femur fractures. Treated with fracture fixation.
Infection onset and evolution	Wound dehiscence and evolution to chronic osteomyelitis of the os ileum with a draining fistula	Non-union distal femur	Postoperative wound problems: multiple episodes of erysipelas, pus drainage, evolution into a draining fistula	Infection of the surgical site with abscess formation and eventually the evolution to osteomyelitis of the femur
Diagnosis	2015	2017	1995	1984
Infected site	Pelvis	Femur	Femur	Femur
Isolated pathogen(s)	P. aeruginosa a S. epidermidis	P. aeruginosa S. epidermidis	S. agalactiae S. aureus	E. faecalis
Initial/previous treatments	Multiple debridements Removal of the osteosynthesis material Hyperbaric oxygen therapy Multiple courses of antibiotic therapy Temporary coverage of the wound with negative-pressure wound therapy	Multiple debridements Removal of the osteosynthesis material Multiple courses of antibiotic therapy	Multiple debridements Removal of the osteosynthesis material Multiple courses of antibiotic therapy Local (topical) treatment	Multiple debridements Removal of the osteosynthesis material Placement of gentamicin-coated beads Multiple courses of antibiotic therapy Local (topical) treatment
Antibiotic therapy used with phages and duration	Vancomycin iv Rifampicin po b Moxifloxacin po c Total duration: 3 months	Vancomycin iv Colistin iv Fosfomycin iv Total duration: 6 weeks	Vancomycin iv ↔ Clindamycin po Moxifloxacin po Total duration: 3 months	Amoxicillin iv ↔ Amoxicillin po Total duration: 3 months
Phages used and duration	BFC 1 Total duration: 7 days	BFC 1 Total duration: 10 days	BFC 1 Total duration: 9 days	Pyo bacteriophage Total duration: 7 days

^a This bacterial strain was not stored; thus, phage susceptibility could not be tested. The pathogen was initially treated with intravenous antibiotics for a total duration of more than five months, after which the strain could no longer be isolated for several months. Definitive antibiotics used in combination with phages, therefore, do not cover this strain, but considering the patient’s medical history with multiple recurrences with the P. aeruginosa strain, even after previous treatment with colistin, it was decided to apply BFC 1. ^bRifampicin was started once wounds were dry and drains were removed. ^cAntibiotic therapy was modified based on tissue culture results from the final surgery, which showed the presence of Morganella morganii, sensitive to fluoroquinolones. iv: intravenous therapy; po: oral therapy; ↔: switch from intravenous therapy to oral therapy.