Small study finds promise in phage therapy for cystic fibrosis patients

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Small study finds promise in phage therapy for cystic fibrosis patients

Bacteriophage illustration
iLexx / iStock

Bacteriophage therapy for chronic bacterial respiratory infections appears to be safe and well-tolerated in cystic fibrosis (CF) patients, according to a study published yesterday in the International Journal of Infectious Diseases.

Because of the thick, sticky mucus that builds up in their lungs, CF patients are predisposed to chronic respiratory infections and colonization by intrinsically multidrug-resistant (MDR) pathogens like Pseudomonas aeruginosa. This requires repeated exposure to antibiotics, which accelerates the emergence of MDR strains and further limits treatment options. 

As a result, CF patients have become prime candidates for treatment with bacteriophages, which are live viruses that specifically target and kill bacteria. But because phage therapy to date has been used only in limited circumstances, evidence on safety and efficacy is scarce.

“The heterogeneity in treatment protocols, outcome measures, and follow-up periods across existing studies limits the ability to draw definitive conclusions about the efficacy and safety of phage therapy in CF patients,” researchers from Italy and the United States wrote. 

Larger studies needed

To evaluate current evidence, the researchers conducted a systematic review and meta-analysis of 19 studies involving 51 CF patients and 52 bacteriophage treatments, which were administered in conjunction with antibiotics. Among the included studies were two randomized controlled trials, six case series, and 11 case reports. Nearly half the patients (46%) had P aeruginosa infections. Other pathogens included Mycobacterium abscessus, Achromobacter spp, Burkholderia spp, and Staphylococcus aureus.

Overall microbiologic improvement, defined as bacterial load reduction in specimen cultures, was achieved in 35 of 51 patients (68.8%), and lung function improved in 20 of 27 patients (74.1%). Forty-one of 52 patients (78.8%) experienced no adverse events directly attributable to phage therapy. Two patients reported serious adverse events, but they were considered unlikely to be related to treatment. 

The study authors say the results support “the potential for phage therapy as a versatile therapeutic platform in CF management,” but add that the small sample size and non-randomized evidence “necessitate cautious interpretation and underscore the critical need for larger, well-designed randomized clinical trials with standardized outcomes and extended follow-up to confirm these promising preliminary results.”


Article taken from, copyright belongs to : https://www.cidrap.umn.edu/antimicrobial-stewardship/small-study-finds-promise-phage-therapy-cystic-fibrosis-patients

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