Abstract

We have entered the post-antibiotic era. Phage therapy has recently been given renewed attention because bacteriophages are easily available and can kill bacteria. Many reports have demonstrated successful phage treatment of bacterial infection, whereas some studies have shown that phage therapy is not as effective as expected. In general, establishment of a standard operating procedure will ensure the success of phage therapy. In this paper, the whole operating procedure for phage therapy in clinical practice is explored and analyzed to comprehensively understand the success of using phage for the treatment of bacterial infectious disease in the future. The procedure includes the following: enrollment of patients for phage therapy; establishment of phage libraries; pathogenic bacterial isolation and identification; screening for effective phages against pathogenic bacteria; phage formulation preparation; phage preparation administration strategy and route; monitoring the efficacy of phage therapy; and detection of the emergence of phage-resistant strains. Finally, we outline the whole standard operating procedure for phage therapy in clinical practice. It is believed that phage therapy will be used successfully, especially in personalized medicine for the treatment of bacterial infectious diseases. Hopefully, this procedure will provide support for the entry of phage therapy into the clinic as soon as possible.

Highlights

  • Humans have entered the “post-antibiotic” era, in which existing antibacterial agents fail to kill drug-resistant bacteria that cause infections [1, 2]

  • As antibiotic resistance in bacteria becomes serious, scientists are exploring new strategies to control bacterial infection, especially infections caused by pandrug-resistant bacteria [1, 4, 5]

  • The establishment of a phage library is the foundation of a successful therapy

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Summary

Introduction

Humans have entered the “post-antibiotic” era, in which existing antibacterial agents fail to kill drug-resistant bacteria that cause infections [1, 2]. As antibiotic resistance in bacteria becomes serious, scientists are exploring new strategies to control bacterial infection, especially infections caused by pandrug-resistant bacteria [1, 4, 5]. Phages can kill bacteria and have been used for treating infections, including diarrhea and skin infections caused by Shigella dysenteriae and Staphylococcus aureus, respectively [9]. The discovery of antibiotics, subsequent large-scale industrial production, and wide clinical application have caused phage therapy to become unfavorable [4, 10]. Studies of phage therapy nearly stopped for a long time in part due to its largely controversial efficacy [11]

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