TY - JOUR
T1 - Bacteriophage application for difficult-to-treat musculoskeletal infections: development of a standardized multidisciplinary treatment protocol
AU - Onsea, Jolien
AU - Soentjens, Patrick
AU - Djebara, Sarah
AU - Merabishvili, Maia
AU - Depypere, Melissa
AU - Spriet, Isabel
AU - De Munter, Paul
AU - Debaveye, Yves
AU - Nijs, Stefaan
AU - Vanderschot, Paul
AU - Wagemans, Jeroen
AU - Pirnay, Jean-Paul
AU - Lavigne, Rob
AU - Metsemakers, Willem-Jan
N1 - FTX; DOAJ; (CC BY 4.0)
PY - 2019/9/23
Y1 - 2019/9/23
N2 - Bacteriophage therapy has recently attracted increased interest, particularly in difficult-to-treat infections. Although it is not a novel concept, standardized treatment guidelines are currently lacking. We present the first steps towards the establishment of a "multidisciplinary phage task force" (MPTF) and a standardized treatment pathway, based on our experience of four patients with severe musculoskeletal infections. After review of their medical history and current clinical status, a multidisciplinary team found four patients with musculoskeletal infections eligible for bacteriophage therapy within the scope of Article 37 of the Declaration of Helsinki. Treatment protocols were set up in collaboration with phage scientists and specialists. Based on the isolated pathogens, phage cocktails were selected and applied intraoperatively. A draining system allowed postoperative administration for a maximum of 10 days, 3 times per day. All patients received concomitant antibiotics and their clinical status was followed daily during phage therapy. No severe side-effects related to the phage application protocol were noted. After a single course of phage therapy with concomitant antibiotics, no recurrence of infection with the causative strains occurred, with follow-up periods ranging from 8 to 16 months. This study presents the successful outcome of bacteriophage therapy using a standardized treatment pathway for patients with severe musculoskeletal infection. A multidisciplinary team approach in the form of an MPTF is paramount in this process.
AB - Bacteriophage therapy has recently attracted increased interest, particularly in difficult-to-treat infections. Although it is not a novel concept, standardized treatment guidelines are currently lacking. We present the first steps towards the establishment of a "multidisciplinary phage task force" (MPTF) and a standardized treatment pathway, based on our experience of four patients with severe musculoskeletal infections. After review of their medical history and current clinical status, a multidisciplinary team found four patients with musculoskeletal infections eligible for bacteriophage therapy within the scope of Article 37 of the Declaration of Helsinki. Treatment protocols were set up in collaboration with phage scientists and specialists. Based on the isolated pathogens, phage cocktails were selected and applied intraoperatively. A draining system allowed postoperative administration for a maximum of 10 days, 3 times per day. All patients received concomitant antibiotics and their clinical status was followed daily during phage therapy. No severe side-effects related to the phage application protocol were noted. After a single course of phage therapy with concomitant antibiotics, no recurrence of infection with the causative strains occurred, with follow-up periods ranging from 8 to 16 months. This study presents the successful outcome of bacteriophage therapy using a standardized treatment pathway for patients with severe musculoskeletal infection. A multidisciplinary team approach in the form of an MPTF is paramount in this process.
KW - Anti-Bacterial Agents/pharmacology
KW - Bacteria/classification
KW - Bacteriolysis
KW - Bacteriophages
KW - Clinical Protocols/standards
KW - Combined Modality Therapy
KW - Drug Resistance, Multiple, Bacterial
KW - Humans
KW - Microbial Sensitivity Tests
KW - Musculoskeletal Diseases/microbiology
KW - Osteomyelitis/microbiology
KW - Patient Care Team/standards
KW - Perioperative Period
KW - Phage Therapy/methods
KW - Treatment Outcome
U2 - 10.3390/v11100891
DO - 10.3390/v11100891
M3 - A1: Web of Science-article
C2 - 31548497
SN - 1999-4915
VL - 11
JO - Viruses
JF - Viruses
IS - 10
M1 - 891
ER -