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Review indicates phage therapy safe, effective against ESKAPE pathogens
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A systematic review of published studies showed that phage therapy is a safe and effective treatment for infections caused by multidrug-resistant pathogens, researchers said.
“The emergence of multidrug-resistant organisms (MDROs) poses a serious threat to public health worldwide,” Lynn El Haddad, PhD, from the department of infectious diseases, infection control and employee health at the University of Texas MD Anderson Cancer Center, and colleagues wrote in Clinical Infectious Diseases.
“The most problematic MDROs are antibiotic-resistant ESKAPE pathogens; Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species,” they wrote. “Their emergence as MDROs is the result of excessive antibiotic use in the clinical and agricultural settings, as well as the slow pace of development of new antimicrobial agents.”
According to the authors, there is a “crucial and unmet need” for new preventive strategies to fight emerging multidrug-resistant pathogens, opening the door for phage therapy. Bacteriophages — also called phages — are a natural way to prevent and control MDROs, specifically antibiotic-resistant ESKAPE pathogens, according to Haddad and colleagues. The authors noted that the viruses can specifically target and kill a range of bacteria without disrupting the host’s normal microbiota.
According to their report, data on the efficacy and safety of using phage therapy against ESKAPE pathogens are scarce. They searched PubMed, Ovid, EMBASE and Cochrane Library databases for articles on phage therapy published between 1985 and 2018, as well as pharmaceutical company trial registers and national and international meeting presentations for additional articles.
In total, Haddad and colleagues identified 1,102 articles and reviewed 30 for the study, with most evaluating the use of phage cocktails rather than single phages, they said. The studies included more than 1,150 patients aged 6 months to 101 years infected with ESKAPE pathogens. In all, 87% of the studies found phage therapy to be effective against targeted bacteria, and 67% showed the tested phages were safe, with no connection between treatment and patient deaths or adverse side effects.
The researchers noted that two studies showed side effects after phage treatment. However, there were limited data to confirm their relation to phage therapy.
“In this era of emerging antimicrobial resistance, clinical phage therapy seems to be an effective and safe strategy for mitigating the impact of MDROs,” the authors concluded. “This strategy may prove to be effective, and safe for patients with highly resistant bacterial infections and may curtail bacterial resistance to available antibiotics.” – by Caitlyn Stulpin
Disclosures: The authors report no relevant financial disclosures.
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