A novel sustained‐release matrix based on biodegradable poly(ester amide)s and impregnated with bacteriophages and an antibiotic shows promise in management of infected venous stasis ulcers and other poorly healing wounds

Abstract

Healing of poorly vascularized and venous stasis ulcers is often refractory to therapy, particularly when they are infected. Systemic antibiotic therapy may be of little benefit in this setting because of poor penetration of the antibiotic into the wound and the frequent associated emergence of bacterial strains resistant to common antimicrobial agents. Given the clinical significance of these problems, there is a need to explore alternative management approaches for these difficult-to-treat wounds. PhagoBioDerm is a novel wound-healing preparation consisting of a biodegradable polymer impregnated with an antibiotic and lytic bacteriophages, which was recently licensed for sale in the Republic of Georgia (one of the former Soviet Union republics). In 1999-2000, in Tbilisi, Georgia, 107 patients who had ulcers that had failed to respond to conventional therapy were treated with PhagoBioDerm alone or in combination with other interventions. The wounds/ulcers healed completely in 67 (70%) of 96 patients for whom follow-up data were available. In 22 cases in which microbiologic data were available, healing was associated with the concomitant elimination of, or a reduction in, specific pathogenic bacteria in the ulcers. Our findings suggest that this slow-release biopolymer is safe and of possible benefit in the management of refractory wounds, and they support the apparent utility of bacteriophages in this setting. Further studies, including carefully designed clinical trials, will be required to rigorously evaluate the efficacy of this novel wound dressing preparation.

Bacteriophage Cocktail for the Prevention of Biofilm Formation by Pseudomonas aeruginosa on Catheters in an In Vitro Model System

“…Markoishvili et al (31) developed a nontoxic polymer film (PhagoBioDerm) that was impregnated with phages, ciprofloxacin, and benzocaine, and it has been used to treat patients with different infectious diseases. Biofilms may be implicated in some of these types of infections; however, an explicit evaluation of PhagoBioDerm against biofilms has not been published.…”

Bacteriophages: the possible solution to treat infections caused by pathogenic bacteria

“…Later on, bacteriophages were produced commercially by integrating a cocktail of phages with a biodegradable polymer and an antibiotic (ciprofloxacin) to give the best effect as a dressing against multidrug-resistant bacteria like S. aureus. The commercial name of this product is PhagoBioDerm (Markoishvili et al 2002;Jikia et al 2005). Consideration should be given to the potential release of endotoxin caused by bacteriophage-induced lysis, which may stimulate an inflammatory response.…”

Innovative methods of biofilm treatment in chronic wounds

“…Zastosowano fagi przeciwko S. aureus, P. aeruginosa oraz E. coli [56]. Inne badania [57], którymi również zostali objęci pacjenci z owrzodzeniami w wyniku przewlekłej niewydolności żylnej, potwierdziły skuteczność terapii fagowej w tej grupie chorych. Pacjentom, którzy nie odpowiadali na konwencjonalną terapię, aplikowano preparat składający się z biodegradowalnego polimeru impregnowanego antybiotykiem oraz bakteriofagami litycznymi.…”

“…Jedynie u 5 pacjentów, u których chorobą współistniejącą była cukrzyca, terapia okazała się nieskuteczna. Nie stwierdzono żadnych ogólnoustrojowych działań niepożądanych w całej grupie badanej [57].…”