Phage therapy: an alternative treatment modality for MDR bacterial infections

Infect Dis (Lond). 2024 Oct;56(10):785-817. doi: 10.1080/23744235.2024.2379492. Epub 2024 Jul 17.

Abstract

The increasing global incidence of multidrug-resistant (MDR) bacterial infections threatens public health and compromises various aspects of modern medicine. Recognising the urgency of this issue, the World Health Organisation has prioritised the development of novel antimicrobials to combat ESKAPEE pathogens. Comprising Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp. and Escherichia coli, such pathogens represent a spectrum of high to critical drug resistance, accounting for a significant proportion of hospital-acquired infections worldwide. In response to the waning efficacy of antibiotics against these resilient pathogens, phage therapy (PT) has emerged as a promising therapeutic strategy. This review provides a comprehensive summary of clinical research on PT and explores the translational journey of phages from laboratory settings to clinical applications. It examines recent advancements in pre-clinical and clinical developments, highlighting the potential of phages and their proteins, alone or in combination with antibiotics. Furthermore, this review underlines the importance of establishing safe and approved routes of phage administration to patients. In conclusion, the evolving landscape of phage therapy offers a beacon of hope in the fight against MDR bacterial infections, emphasising the imperative for continued research, innovation and regulatory diligence to realise its full potential in clinical practice.

Keywords: Phage therapy; antimicrobial resistance; phage cocktail; phage resistance; phage-antibiotic synergy.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Bacterial Agents* / therapeutic use
  • Bacterial Infections* / microbiology
  • Bacterial Infections* / therapy
  • Bacteriophages* / physiology
  • Drug Resistance, Multiple, Bacterial*
  • Humans
  • Phage Therapy* / methods

Substances

  • Anti-Bacterial Agents