Bacteriophages have great potential in treating patients with joint prosthesis infections, as they act synergistically with antibiotics to disrupt biofilms. A clinical case of treating a recurrent joint prosthesis infection caused by Pseudomonas aeruginosa was published in the journal Frontiers in Medicine.

An 88-year-old male patient weighing 63 kg with recurrent left knee prosthesis infection caused by Pseudomonas aeruginosa experienced a significant deterioration in his general condition. He was on bed rest due to congestive heart failure, and his C-reactive protein level was 100 mg/L. Since neither prosthesis removal nor replacement was possible, phage therapy was proposed.

Three bacteriophages were selected for therapy due to their high lytic activity against the P. aeruginosa strain isolated from the patient. A clinical pharmacist extemporaneously prepared a phage cocktail in suspension form (initial concentration of 1 x 10 ¹⁰ PFU/ml for each phage), which was diluted to a concentration of 1 x 10 ⁹ PFU/ml for each phage before use.

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The patient underwent arthroscopy, and 30 ml of phage preparation was injected through the arthroscope (the PhagoDAIR procedure). Simultaneously, the patient began a 3-week course of antimicrobial therapy: ceftazidime intravenously (IV) 6 g daily and ciprofloxacin orally 500 mg twice daily. Following treatment, the patient's condition rapidly improved, symptoms of congestive heart failure and knee pain disappeared, and C-reactive protein levels returned to normal. After 6 and 12 months, the condition of the left knee remained good, with movement and walking painless.

Thus, the combination of phage therapy (administration of the drug through an arthroscope) and antimicrobial therapy can potentially be used in the treatment of patients with joint prosthesis infections.

* Ferry T, Kolenda C, Batailler C, Gaillard R et al. Case Report: Arthroscopic "Debridement Antibiotics and Implant Retention" With Local Injection of Personalized Phage Therapy to Salvage a Relapsing Pseudomonas Aeruginosa Prosthetic Knee Infection. Front Med (Lausanne) 2021, 8: 569159. doi: 10.3389/fmed.2021.569159.