Phage therapy in patients with urinary tract infections: a systematic review.

IF 4.2 2区医学 Q1 INFECTIOUS DISEASES

Expert Review of Anti-infective Therapy Pub Date : 2025-06-04 DOI:10.1080/14787210.2025.2513459

Romaric Larcher, Aurélien Dinh, Boris Monnin, Paul Laffont-Lozes, Paul Loubet, Jean-Philippe Lavigne, Franck Bruyere, Albert Sotto

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引用次数: 0

Abstract

Introduction: Urinary tract infections (UTIs) caused by multidrug-resistant (MDR) and extensively drug-resistant (XDR) bacteria are challenging to treat. This systematic review evaluates bacteriophage therapy.

Research design and methods: A comprehensive search was conducted in PubMed, Embase, Web of Science, and Cochrane databases. Studies reporting bacteriophage therapy in UTIs, with outcomes related to safety and efficacy, were included. Studies unrelated to UTIs or lacking clear outcomes were excluded. Bias was assessed using RoB2 and JBI appraisal tools for series and case reports. Data were synthesized narratively due to study heterogeneity.

Results: From 576 articles screened, 12 studies met the inclusion criteria, comprising 89 participants, many with MDR and XDR infections. Phage therapy was generally well-tolerated. Efficacy varied, with some studies showing complete infection resolution, particularly in high-risk patients, while others reported partial or no improvement. Phage therapy often served as the sole viable treatment for XDR infections, yielding positive results despite small sample sizes and data heterogeneity.

Conclusions: Phage therapy shows promise as an alternative or adjunct to antibiotics for UTIs, especially those with limited treatment options, but uncertainties remain regarding dosing and administration. Further randomized trials are needed to confirm its efficacy and safety.

Protocol registration: www.crd.york.ac.uk/prospero identifier isCRD42023431617.

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噬菌体治疗尿路感染：系统综述。

导读：由多重耐药（MDR）和广泛耐药（XDR）细菌引起的尿路感染（uti）的治疗具有挑战性。本系统综述评估了噬菌体治疗作为uti抗生素的替代或辅助治疗。研究设计与方法：在PubMed、Embase、Web of Science、Cochrane等数据库中进行全面检索。研究报告了噬菌体治疗尿路感染，其结果与安全性和有效性相关。与尿路感染无关或缺乏明确结果的研究被排除在外。使用系列和病例报告的RoB2和JBI评估工具评估偏倚。由于研究异质性，数据采用叙述性合成。结果：从筛选的576篇文章中，12项研究符合纳入标准，包括89名参与者，其中许多患有MDR和XDR感染。总的来说，噬菌体疗法耐受性良好，几乎没有不良反应。疗效各不相同，一些研究显示完全解决了感染，特别是在高危患者中，而另一些研究报告部分改善或没有改善。噬菌体治疗通常作为XDR感染的可行治疗方法，尽管样本量小且数据不均匀，但结果呈阳性。结论：噬菌体疗法有望治疗尿路感染，特别是那些治疗方案有限的患者，但剂量和给药方面仍存在不确定性。需要进一步的随机试验来证实其有效性和安全性。协议注册：www.crd.york.ac.uk/prospero标识符isCRD42023431617。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Anti-infective Therapy 医学-药学

CiteScore

11.20

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.