Application of bacteriophages in clinical practice

Introduction: Among the issues related to the use of medical care in intensive care units (ICUs), the leading place is occupied by hospital or ventilator-associated pneumonia. One of the promising methods of preventing respiratory infectious diseases in ICU may be adaptive phage therapy.

Methods: The study included patients (n=41) with an average age of 54 years (28% men) and a control group (n=38) with an average age 59 of years (19% men). Adaptive phage therapy was administered by inhalation (5.0 ml, 3 times a day) from the first day of stay of patients of the main group (n=41) for at least 21 days in the intensive care unit of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology. The control group (n=38) consisted of patients who received standard therapy in accordance with current recommendations for pneumonia. The taxonomic composition and resistance genes of endotracheal aspirate were assessed via PCR testing using Amplisens reagents (Russia) on CFX 96 (BioRad; USA).

Results: Over the entire study period, 24 (58.5%) patients in the main group (n=41) had no recurrence of nosocomial pneumonia and did not require antibiotics, while in the control group (n=38), only 11 (26.3%) patients did not need antibiotic therapy. A statistically significant decrease in the number of pathogens in the study group compared to the control (p=0.008) suggests the possibility of the effective use of a complex preparation of bacteriophages.

Conclusions: In the long term, the use of bacteriophages helps to improve the quality of treatment, reduce the number of recurrent infections, and reduce the use of antibiotics.