Table I.
Summary of recent clinical studies utilizing bacteriophage therapy.
| Study | Clinical diagnosis, n | Bacteria species | Treatment approach | Clinical outcome |
|---|---|---|---|---|
| Fish et al33 | Diabetic toe ulcers with S. aureus infected bone and soft tissue (n = 6) | S. aureus | Topical application of phage solution to ulcer | Ulcers healed generally in seven weeks; one patient required 18 weeks of treatment |
| Fish et al34 | Distal phalangeal osteomyelitis (n = 1) | S. aureus (MRSA) | Phage solution injection into the soft tissue surrounding the distal phalanx | Reossification of the distal phalanx within 3 mths; 3 yr follow-up patient still free of osteomyelitis |
| Ferry et35 | Osteomyelitis adjacent to the cement located in the right sacroiliac joint (n = 1) | P. aeruginosa | Phage solution injection into the cavity in contact with bone every 3 days, totalling 4 administrations; also antibiotic therapy | Rapid healing within 14 days with no presence of bacteria |
| Ferry et al36 | PJI of the right hip (n = 1) | S. aureus | Phage solution injection into the joint; also antibiotic therapy | Favourable outcome at 18 mths post-treatment without any clinical signs of persistent infection |
| Onsea et al37 | Severe musculoskeletal (pelvis/femur) infections, osteomyelitis (n = 4) |
P. aeruginosa;
S. epidermidis; S. agalactiae; S. aureus; E. faecalis |
Phage solution delivered through draining system in close contact with infected bone; collagen sponge soaked in phage solution was placed on the infected bone prior to wound closure; phage solution three times per day for 7 to 10 days; also antibiotic therapy | With single course of phage therapy, no recurrence of infection in periods ranging from 8 to 16 mths |
| LaVergne et al38 | Traumatic brain injury and craniectomy complicated by postoperative infection (n = 1) | A. baumannii | Phage solution administered intravenously every 2 hrs for 8 days | No further signs of infection at the craniotomy site |
| Patey et al39 | Pelvic bone infection (n = 1); Complex fracture of right foot (n = 1); mandibular fracture, osteosynthesis, and fistulized infection (n = 1); Femoral fracture under hip prosthesis (n = 1); Left knee prosthesis infection (n = 1); Osteomyelitis of the left tibia (n = 1); Left tibia fracture, followed by reopened bone infection (n = 1) |
S. aureus (n = 3); P. aeruginosa; S. aureus (MRSA) (n = 3); Staphylococcus sp. |
Phage solution administered preoperatively and via catheter in days following operation (n = 3); Phage solution administered peroperatively (n = 3); Surgery, phage therapy with commercial phage suspension; also antibiotic therapy |
Complete cure (n = 5); Initial partial disinfection; Disappearance of S. aureus |
| Nir-Paz et al40 | Left bicondylar tibial plateau fracture (n = 1) |
A. baumannii;
K. pneumoniae |
Phage solution delivered intravenously over 35 mins and over 5 days; second treatment course was given for an additional 6 days, one week later | Graft healing; elimination of subtle chronic bone pain; 8 mth post-treatment follow-up indicated no positive cultures for either bacterial strain |
| Tkhilaishvili et al41 | Right knee peri prosthetic infection and chronic osteomyelitis of the femur (n = 1) | P. aeruginosa | Phage solution applied locally during surgery followed by additional phage solution every 8 hrs through each of the four drains as a local delivery system for five days; also antibiotic therapy | Eradication of infection, and no side effects: 10 mth follow-up visit patient reported no pain in the right knee |
A. baumannii, Acinetobacter baumannii; E. faecalis, Enterococcus faecalis; K. pneumoniae, Klebsiella pneumoniae; MRSA, methicillin-resistant Staphylococcus aureus; P. aeruginosa, Pseudomonas aeruginosa; S. agalactiae, Streptococcus agalactiae; S. aureus, Staphylococcus aureus; S. epidermidis, Staphylococcus epidermidis