Harvard Combined Orthopedic Residency Program, Boston, MA 02114, USA.
Harvard Medical School, Harvard University, Boston, MA 02115, USA.
Medicina (Kaunas). 2024 May 9;60(5):790. doi: 10.3390/medicina60050790.
Despite the promise of phage therapy (PT), its efficacy in prosthetic joint infection (PJI) management is unknown. Much of the current literature is largely limited to case reports and series. In order to help inform power calculations for future clinical trials and comparative analyses, we performed a systematic review and proportional meta-analysis of early PT outcomes to provide a preliminary assessment of early phage therapy treatment outcomes for cases of PJI. In a search of available literature across MEDLINE (Ovid, Wolters Kluwer, Alphen aan den Rijn, The Netherlands), Embase (Elsevier, Amsterdam, The Netherlands), the Web of Science Core Collection (Clarivate, London, UK), and Cochrane Central (Wiley, Hoboken, NJ, USA) up to 23 September 2023, we identified 37 patients with PJIs receiving adjunctive PT. Patients most frequently reported species infection (95%) and intraarticular phage delivery (73%). Phage cocktail (65%) and antibiotic co-administration (97%) were common. A random-effects proportional meta-analysis suggested infection remission in 78% of patients (95% CI: 39%, 95%) ( = 55%, = 0.08) and 83% with a minimum 12-month follow-up (95% CI: 53%, 95%) ( = 26%, = 0.26). Our study provides a preliminary estimate of PT's efficacy in PJIs and informs future comparative studies.
尽管噬菌体疗法（PT）有很大的应用前景，但它在人工关节感染（PJI）管理中的疗效尚不清楚。目前的大部分文献主要局限于病例报告和系列研究。为了帮助为未来的临床试验和比较分析提供疗效计算的依据，我们对早期 PT 结果进行了系统评价和比例荟萃分析，以初步评估 PJI 患者早期噬菌体治疗的结果。我们在 2023 年 9 月 23 日之前对 MEDLINE（Ovid，荷兰阿尔芬）、Embase（Elsevier，荷兰阿姆斯特丹）、Web of Science Core Collection（Clarivate，英国伦敦）和 Cochrane Central（Wiley，美国新泽西州霍博肯）的现有文献进行了搜索，共确定了 37 例接受辅助 PT 的 PJI 患者。患者最常报告的是 种感染（95%）和关节内噬菌体给药（73%）。噬菌体鸡尾酒（65%）和抗生素联合应用（97%）很常见。随机效应比例荟萃分析表明，78%的患者（95%可信区间：39%，95%）（ = 55%， = 0.08）和 83%的患者（95%可信区间：53%，95%）（ = 26%， = 0.26）感染得到缓解，随访时间至少为 12 个月。我们的研究初步估计了 PT 在 PJI 中的疗效，并为未来的比较研究提供了依据。
