Wahl Peter, Schläppi Michel, Loganathan Archana, Uçkay Ilker, Hodel Sandro, Fritz Benjamin, Scheidegger Jens, Djebara Sarah, Leitner Lorenz, McCallin Shawna
Division of Orthopaedics and Traumatology, Cantonal Hospital Winterthur, Winterthur, Switzerland.
Faculty of Medicine, University of Bern, Bern, Switzerland.
Front Med (Lausanne). 2025 Apr 25;12:1564369. doi: 10.3389/fmed.2025.1564369. eCollection 2025.
Treatment failure remains an issue in periprosthetic joint infection (PJI). Bacteriophages offer new treatment options. However, there is still a lack of evidence to better define their usefulness and administration. We report a case in which antibiotic suppression was successful only after administration of bacteriophages.
Antibiotic suppression was the only option for a 94-year-old male with methicillin-resistant (MRSA) PJI of the hip and of the knee. As the hip PJI could not be suppressed adequately, bacteriophages were administered locally and systemically together with daptomycin. This combined approach led to sufficient clinical improvement for further oral antibiotic suppression, although without infection eradication.
The administration of bacteriophages may be a valuable, less-invasive adjunct therapy to successfully suppress PJI. Bacteriophage selection, preparation and administration, however, remains associated with administrative obstacles, greatly limiting availability and practicability. Nevertheless, research and developments in this domain should be pursued, particularly considering issues with future antibiotic limitations and cost associated with treatment failure in PJI.
假体周围关节感染（PJI）的治疗失败仍是一个问题。噬菌体提供了新的治疗选择。然而，仍然缺乏证据来更好地界定它们的效用和给药方式。我们报告了一例仅在给予噬菌体后抗生素抑制才成功的病例。
对于一名患有髋部和膝部耐甲氧西林金黄色葡萄球菌（MRSA）PJI的94岁男性，抗生素抑制是唯一的选择。由于髋部PJI无法得到充分抑制，噬菌体与达托霉素一起局部和全身给药。这种联合方法导致临床有足够改善，以便进一步进行口服抗生素抑制，尽管未根除感染。
噬菌体给药可能是成功抑制PJI的一种有价值的、侵入性较小的辅助治疗方法。然而，噬菌体的选择、制备和给药仍然存在管理障碍，极大地限制了其可用性和实用性。尽管如此，仍应在该领域进行研究和开发，特别是考虑到未来抗生素的局限性以及PJI治疗失败相关的成本问题。
