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Phage Therapy for Diabetic Foot Infection: A Case Series.

Matthew J Young1, Lesley M L Hall2, Maya Merabishvilli3

  • 1Diabetes Foot Clinic, Out Patient Department 2, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.

Clinical Therapeutics
|July 13, 2023
PubMed
Summary

Topical phage therapy shows promise for treating infected diabetic foot ulcers (DFIs) at high risk of amputation. Nine of ten patients benefited, with no adverse effects reported, suggesting potential for limb salvage and DFI treatment transformation.

Keywords:
BacteriophageDiabetic foot infectionPhage therapy

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Wound Care

Background:

  • Diabetic foot infections (DFIs) are challenging to treat and can lead to amputation.
  • Antibiotic therapy is not always effective for DFIs.
  • Bacteriophages (phages) are viruses that target and kill bacteria, offering an alternative therapeutic approach.

Purpose of the Study:

  • To report on the use of topical adjunctive anti-staphylococcal phage therapy in patients with DFIs at high risk of amputation.
  • To assess the tolerability and clinical efficacy of phage therapy in a real-world clinical setting.

Main Methods:

  • Topical adjunctive anti-staphylococcal phage therapy was administered to 10 patients with DFIs.
  • Treatment was provided as part of routine clinical care at two UK hospitals.
  • Tolerability and efficacy were assessed through clinical observation by experienced medical teams.

Main Results:

  • Nine out of ten patients showed clinical benefit from phage therapy.
  • No adverse effects were reported by patients or clinicians.
  • Phage therapy facilitated clinical resolution of infection and limb salvage in 6 patients; one patient achieved soft tissue infection resolution but required amputation for osteomyelitis.
  • Staphylococcus aureus was eradicated in one polymicrobial infection, and another patient showed improvement before therapy cessation.

Conclusions:

  • This study represents the largest application of phage therapy for DFIs in the UK to date.
  • Adjunctive phage therapy demonstrated promising tolerability and efficacy in this patient cohort.
  • Phage therapy holds significant potential to revolutionize the prevention and treatment of diabetic foot infections.