Phage Therapy for Orthopaedic Infections: The First Three Cases from the United Kingdom

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Orthopaedic Surgery

Background:

• Bacteriophages (phages) are viruses targeting bacteria, offering an alternative to antibiotics.
• The rise of antimicrobial resistance necessitates novel therapeutic strategies.
• Chronic orthopaedic infections present a significant clinical challenge.

Purpose of the Study:

• To report the outcomes of the first three patients treated with phage therapy for chronic orthopaedic infections in the UK.
• To evaluate the safety and efficacy of phage therapy in a clinical setting.

Main Methods:

• Case series of three patients with chronic orthopaedic infections treated with bacteriophage therapy.
• Phages were selected based on their activity against identified bacterial pathogens.
• Clinical outcomes, including wound healing and inflammatory markers, were monitored.

Main Results:

• Patient 1: Treated with phages targeting *Staphylococcus aureus*; achieved wound healing and normalized C-reactive protein at nine months.
• Patient 2: Treated with phages targeting *Klebsiella pneumoniae* and *S. aureus*; infection persisted.
• Patient 3: Treated with phages targeting *Staphylococcus epidermidis*; infection resolved at six months.
• Mild, self-limiting adverse effects in two patients were potentially linked to endotoxins.

Conclusions:

• Phage therapy demonstrates potential as a transformative treatment for chronic orthopaedic infections.
• Further research and clinical trials are warranted to establish phage therapy's role in treating these challenging infections.