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Management of Diabetic Foot Infections Using Phage Therapy.

Mohsen Nazari1, Leili Shokoohizadeh2

  • 1Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

Infection and Drug Resistance
|March 30, 2026
PubMed
Summary

Bacteriophage therapy shows promise for diabetic foot infections (DFIs) caused by antibiotic-resistant bacteria. Further clinical trials are needed to overcome challenges and establish its use alongside standard treatments.

Keywords:
antibioticsdiabetic foot infectionsphage therapy

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Biotechnology

Background:

  • Diabetic foot infections (DFIs) are a growing complication of diabetes, often leading to severe outcomes like amputation.
  • Multidrug-resistant pathogens complicate DFI treatment, necessitating novel therapeutic strategies.
  • Bacteriophage therapy offers a targeted approach against resistant bacteria, biofilms, and has a good safety profile.

Purpose of the Study:

  • To review current evidence on bacteriophage therapy for diabetic foot infections.
  • To evaluate the efficacy and safety of phages against key DFI pathogens.
  • To identify challenges and future directions for clinical implementation of phage therapy.

Main Methods:

  • Systematic review of in vitro studies, animal models, and clinical case series on phage therapy for DFIs.
  • Analysis of phage effectiveness against common DFI pathogens like Staphylococcus aureus and Pseudomonas aeruginosa.
  • Assessment of reported outcomes, including bacterial burden reduction and wound healing.

Main Results:

  • Phage therapy demonstrated efficacy against major DFI pathogens, including multidrug-resistant strains.
  • Preliminary clinical data suggest reduced bacterial load and improved wound healing in some patients.
  • Key pathogens targeted include Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, and Enterococcus species.

Conclusions:

  • Bacteriophage therapy is a potential adjunct for managing DFIs, especially those with resistant infections.
  • Clinical translation requires addressing challenges such as phage specificity, standardization, and regulatory pathways.
  • Further rigorous preclinical and randomized clinical trials are essential to validate phage therapy's utility in DFIs.