Abstract

Bacteriophages (BPs) are viruses that can infect and kill bacteria without any negative effect on human or animal cells. For this reason, it is supposed that they can be used, alone or in combination with antibiotics, to treat bacterial infections. In this narrative review, the advantages and limitations of BPs for use in humans will be discussed. PubMed was used to search for all of the studies published from January 2008 to December 2018 using the key words: “BPs” or “phages” and “bacterial infection” or “antibiotic” or “infectious diseases.” More than 100 articles were found, but only those published in English or providing evidence-based data were included in the evaluation. Literature review showed that the rapid rise of multi-drug-resistant bacteria worldwide coupled with a decline in the development and production of novel antibacterial agents have led scientists to consider BPs for treatment of bacterial infection. Use of BPs to overcome the problem of increasing bacterial resistance to antibiotics is attractive, and some research data seem to indicate that it might be a rational measure. However, present knowledge seems insufficient to allow the use of BPs for this purpose. To date, the problem of how to prepare the formulations for clinical use and how to avoid or limit the risk of emergence of bacterial resistance through the transmission of genetic material are not completely solved problems. Further studies specifically devoted to solve these problems are needed before BPs can be used in humans.

Highlights

  • Bacteriophages (BPs) are viruses that can infect and kill bacteria without any negative effect on human or animal cells

  • Administration of BPs for this purpose dates to about a century ago, mainly based on the studies of a French researcher, Felix d’Herelle. Due to his collaboration with his Georgian colleagues, BP therapy was largely used in the Soviet Union in patients of any age suffering from a wide range of diseases

  • PubMed was used to search for all of the studies published from January 2008 to December 2018 using the key words: “BPs” or “phages” and “bacterial infection” or “antibiotic” or “infectious diseases”

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Summary

INTRODUCTION

Bacteriophages (BPs) are viruses that can infect and kill bacteria without any negative effect on human or animal cells. The positive effects of topical use of BPs to treat bacterial skin infections are partly questioned by the results of the study by Jault et al (2018) the only randomized clinical trial carried out to evaluate impact of BPs on skin infections. These authors randomly assigned adult patients with a burn wound clinically infected with P. aeruginosa to receive a cocktail of 12 BPs (PP1131; 1 × 106 PFU/mL) or standard of care (1% sulfadiazine silver emulsion cream), both administered topically, once a day for 7 days, with 14 days of follow-up. This can lead to costly and time-consuming clinical trials that could

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