A retrospective analysis of changes in inflammatory markers in patients treated with bacterial viruses

Bacteriophages are increasingly considered an alternative to antibiotics for the treatment of bacterial infections. Clinical improvement may be associated with a lowering of inflammatory markers during the antibiotic treatment of bacterial infections. Some experimental data suggest that phage treatment may have anti-inflammatory properties. We present a retrospective analysis of C-reactive protein (CRP) serum concentration, erythrocyte sedimentation rate (ESR), and white blood cell count (WBC) measured in patients with chronic, symptomatic, antibiotic therapy-resistant bacterial infections who qualified for phage treatment within the protocol "Experimental Phage Therapy of Antibiotic Therapy-Resistant Infections, Including MRSA Infections". Data collected from 37 patients with osteomyelitis (with or without metal implants or joint endoprosthesis) or skin and soft tissue or lower respiratory tract infection induced by, in the majority of cases, S. aureus were analyzed. Phage preparations (natural phage lysates) were administered orally (one 10-ml ampoule three times daily after neutralization of gastric juice with 10 ml of dihydroxyaluminium sodium carbonate) and/or locally (one ampoule two times daily for wet compresses or irrigation of a fistula). No significant changes in mean serum levels of CRP measured after 5-8 days of phage administration were observed compared with the baseline CRP levels measured before therapy (35.7 vs. baseline 38.6 mg/l, n = 11). However, a significant decrease in mean CRP values measured later, between days 9 and 32, was noted (16.1 vs. baseline 23.3 mg/l, n = 26, P < 0.05). Similar tendencies were observed in the changes in mean WBC values, but mean ESR in the patients before, in the early phase, and later during therapy did not change significantly. This is the first report suggesting that the application of phage preparations may probably influence and diminish the inflammatory reaction that accompanies bacterial infection.