Duplessis Christopher Anthony, Biswas Biswajit
Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA.
Antibiotics (Basel). 2020 Jul 4;9(7):377. doi: 10.3390/antibiotics9070377.
The advent and increasing prevalence of antimicrobial resistance commensurate with the absence of novel antibiotics on the horizon raises the specter of untreatable infections. Phages have been safely administered to thousands of patients exhibiting signals of efficacy in many experiencing infections refractory to antecedent antibiotics. Topical phage therapy may represent a convenient and efficacious treatment modality for chronic refractory infected cutaneous wounds spanning all classifications including venous stasis, burn-mediated, and diabetic ulcers. We will initially provide results from a systematic literature review of topical phage therapy used clinically in refractorily infected chronic wounds. We will then segue into a synopsis of the preparations for a forthcoming phase II a randomized placebo-controlled clinical trial assessing the therapeutic efficacy exploiting adjunctive personalized phage administration, delivered topically, intravenously (IV) and via a combination of both modalities (IV + topical) in the treatment of infected diabetic foot ulcers (perhaps the canonical paradigm representing complicated recalcitrant infected cutaneous wounds).
随着抗菌药物耐药性的出现及其日益普遍，同时又缺乏新的抗生素，引发了无法治疗感染的幽灵。噬菌体已被安全地施用于数千名患者，在许多对先前抗生素难治的感染中显示出疗效信号。局部噬菌体疗法可能是一种方便且有效的治疗方式，适用于所有类型的慢性难治性感染性皮肤伤口，包括静脉淤滞性、烧伤介导性和糖尿病性溃疡。我们将首先提供对临床上用于难治性感染性慢性伤口的局部噬菌体疗法进行系统文献综述的结果。然后，我们将概述即将进行的II期随机安慰剂对照临床试验的准备情况，该试验评估利用辅助性个性化噬菌体给药（局部、静脉内（IV）以及两种方式联合（IV + 局部））治疗感染性糖尿病足溃疡（这可能是代表复杂顽固性感染性皮肤伤口的典型范例）的治疗效果。
