Phage Therapy in the Management of Urinary Tract Infections: A Comprehensive Systematic Review

Abstract

Urinary tract infections (UTIs) are a problem worldwide, affecting almost half a billion people each year. Increasing antibiotic resistance and limited therapeutic options have led to the exploration of alternative therapies for UTIs, including bacteriophage (phage) therapy. This systematic review aims at evaluating the efficacy of phage therapy in treating UTIs. We employed a comprehensive search strategy for any language, any animal, and any publication date. A total of 55 in vivo and clinical studies were included. Of the studies, 22% were published in a non-English language, 32.7% were before the year 1996, and the rest were after 2005. The results of this review suggest that phage therapy for UTIs can be effective; more than 72% of the included articles reported microbiological and clinical improvements. On the other hand, only 5 randomized controlled trials have been completed, and case reports and case series information were frequently incomplete for analysis. Overall, this comprehensive systematic review identifies preliminary evidence supporting the potential of phage therapy as a safe and viable option for the treatment of UTIs.

It’s uncomplicated: Prevention of urinary tract infections in an era of increasing antibiotic resistance

“…Antimicrobial and diuretic properties Contains berberine with antimicrobial effects Used as a diuretic to flush out bacteria [32] Drinking extra water Helps flush out bacteria due to more frequent urination [33] Hygiene practices Wiping front to back, and urinating before and after intercourse can reduce UTI risk [7] TREATMENT Antibiotics Inhibit the growth of bacteria; many uropathogens are becoming resistant to commonly available drugs [25] Bacteriophages (phages) Viruses that infect and kill bacteria. Show promise as an antibiotic alternative, especially for resistant strains, but their host specificity requires careful matching of bacterium to phage [34] Methenamine hippurate An older drug that is converted to formaldehyde in the urine and acts as an antiseptic, killing bacteria [25] https://doi.org/10.1371/journal.ppat.1011930.t001…”

Potential of an Isolated Bacteriophage to Inactivate Klebsiella pneumoniae: Preliminary Studies to Control Urinary Tract Infections

“…Therefore, researchers worldwide are exploring their potential applications in various fields [11]. Given that patients in intensive care units are prone to UTIs [12,13], the use of phages to treat these infections has received considerable attention [14]. Commercially available phage preparations from the ELIAVA Institute have been used against isolated E. coli and K. pneumoniae strains obtained from UTI patients [15].…”

Discovery and characterisation of new phage targeting uropathogenicEscherichia coli

“…Using phages against UPEC in UTIs is an emerging treatment option due to their ability to reduce or eliminate antibiotic resistant bacterial populations that cannot be addressed with antibiotics alone (Zalewska-Piatek and Piatek 2020;Al-Anany et al 2023).…”