My new story for the Medical Post/Canadian Healthcare Network.
#Doctors and #pharmacists in Canada can log on for free. Here are a few paragraphs.

Could a century old treatment be an answer to antibiotic resistance?
In a first in Canada, a patient with an #antibiotic resistant artificial joint infection has received treatment with phage therapy and is showing promising early responses.

“This is cutting edge stuff, and a potentially new technology,” said Dr. Marisa Azad, the infectious diseases physician who treated the patient. She is also an assistant professor of medicine at the University of Ottawa.

The patient presented with severe periprosthetic joint infection (PJI) in the summer of 2023. She had already undergone multiple surgeries and had experienced several relapses and infections with the same persistent bacteria.

“She’d been on multiple very prolonged courses of antibiotics and had a severe drug allergy to two major drug classes of antibiotics. I was extremely limited in what I could use to treat her,” Dr. Azad told the Medical Post in an interview.

That’s when the idea arose of trying an experimental treatment course with phage therapy. The team got approval for doing the experimental treatment from Health Canada, and worked with Winnipeg-based Cytophage, which supplied the phages.

“We developed a protocol and gave her therapy over two weeks while she was admitted to hospital. She’s completed her therapy. Now we’re monitoring her closely and giving her adjunctive antibiotics,” she said.

The idea didn’t come out of the blue. In the medical literature, a study from just last year in Clinical #Infectious Diseases provided a review of 33 previously published cases of patients with end-stage, refractory bone and joint infections (BJI) who underwent treatment with phage therapy. The authors found that from those case reports, “29 (87%) achieved microbiological or clinical success, two (5.9%) relapsed with the same organisms, and two (5.9%) with a different organism” with no serious adverse events.

The conclusions of that paper stated there were “important advantages, disadvantages, and barriers to the implementation of phage therapy for BJIs.” Yet, at the same time, the authors added they, “believe that if phage therapy were to be used earlier in the clinical course, fewer cumulative antibiotics may be needed in an individual treatment course.”

The word phage is short for #bacteriophage, a word coined in 1917—literally meaning bacteria-eater. They are viruses whose lifecycle depends on certain types of bacteria.

“They latch on to specific types of bacteria and inject their genetic material into the bacterial cell." Dr. Azad explained. "They take over the bacterial cells’ machinery to produce more little viruses inside and explode or burst open the bacteria,” releasing viral particles that can go and infect other cells of the same type of bacteria.

Intriguingly, each #phage targets a specific type of #bacteria...
The story of phages started over 100 years ago. They were independently discovered, first in 1915 by a British pathologist, Frederick Twort, and then again in 1917 by French-Canadian microbiologist Felix d’Herelle. And...

#MedMastodon #IDmastodon #microbiology @medmastodon
https://www.canadianhealthcarenetwork.ca/could-century-old-treatment-be-answer-antibiotic-resistance