Phage therapy of wound-associated infections

Abstract

Phages are viruses which can specifically infect bacteria, resulting in their destruction. Bacterial infections are a common complication of wound healing, and experimental evidence from animal models demonstrates promising potential for phage-dependent eradication of wound-associated infections. The studies discussed suggest that phage therapy may be an effective treatment, with important advantages over some current antibacterial treatments. Phage cocktails, as well as co-administration of phages and antibiotics, have been reported to minimise bacterial resistance. Further, phage-antibiotic synergism has been reported in some studies. The ideal dose of phages is still subject to debate, with evidence for both high and low doses to yield therapeutic effects. Novel delivery methods, such as hydrogels, are being explored for their advantages in topical wound healing. There are more and more Good Manufacturing Practice facilities dedicated to manufacturing phage products and phage therapy units across the world, showing the changing perception of phages which is occurring. However, further research is needed to secure the place of phages in modern medicine, with some scientists calling upon the World Health Organisation to help promote phage therapy.

Alternatives Therapeutic Approaches to Conventional Antibiotics: Advantages, Limitations and Potential Application in Medicine

“… Priority list for development of new antibiotics according to the World Health Organization. Adapted from (Zyman A; et al, 2022) [ 6 ]. …”

A thermosensitive hydrogel formulation of phage and colistin combination for the management of multidrug-resistant Acinetobacter baumannii wound infections

“…Recently, bacteriophage ( phage) therapy has been adopted as a renewed strategy to combat infections caused by MDR bacteria. 15,16 However, phage monotherapy likely fails to evolve into a robust antimicrobial treatment due to a number of drawbacks, chief among which is the generation of phageresistant phenotypes (i.e. bacteria develop resistance to phages) through mutation or acquisition of phage-resistant genes.…”

Immobilization of Bacteriophages in Ex Tempore Hydrogel for the Treatment of Burn Wound Infection

“…The most promising carriers which function as a matrix for bacteriophage immobilization are hydrogels [ 19 ]. Recently, hydrogels based on sodium alginate, hydroxypropyl methylcellulose, polyethylene glycol-4-maleimide, polyurethane, isopropylacrylamide-coallylamine, and hyaluronic acid methacrylate have been actively used to immobilize bacteriophages in the area of clinical interest [ 20 ].…”