A systematic review found that phage therapy is effective and safe for treating infections caused by ESCAPE bacteria, pathogens that are most often resistant to antibiotics and are responsible for the majority of hospital-acquired infections.

ESCAPE is not only an acronym for the bacteria Enterococcus faecium , Staphylococcus aureus , Klebsiella pneumoniae , Acinetobacter baumannii , and Pseudomonas aeruginosa , members of the Enterobacteriaceae family, but also a play on words: " escape " means to slip away. ESCAPE pathogens are known for frequently evading a wide range of antibiotics.

The spread of multidrug-resistant bacterial strains requires urgent research into ways to combat them. A promising approach to treating multidrug-resistant infections is the use of pathogen-specific bacteriophages—phage therapy.

A team of scientists from the University of Texas (USA) published a systematic review* in the journal Clinical Infectious Diseases, summarizing and critically evaluating studies on the use of bacteriophages in clinical practice. The review also presents criteria and recommendations for clinicians and scientists on effective phage therapy. Of 1,102 articles found in PubMed, Ovid, EMBASE, and the Cochrane Library, 30 were selected for analysis. These articles met certain criteria (target bacteria, patient cohorts, and study design). Most studies used phage cocktails rather than single-agent preparations.

In total, these 30 studies involved more than 1,105 patients aged 6 months to 101 years with infections caused by ESKAPE pathogens. In 87% of studies, phage therapy was effective against the target pathogens. In 67%, the phage preparations used were shown to be safe. Two studies recorded adverse events following phage therapy, but a direct link to phage therapy was not proven.

"In an era of growing antimicrobial resistance, clinical phage therapy appears to be an effective and safe strategy for reducing the burden of multidrug-resistant microorganisms," the review authors note. "Clinical trials and regulatory changes are needed to study the efficacy and safety of phages and expand their use in the treatment of multidrug-resistant infections."

* Haddad LE, Harb CP, Gebara MA et al. A Systematic and Critical Review of Bacteriophage Therapy against Multi-Drug Resistant ESKAPE Organisms in Humans // Clinical Infectious Diseases, Published: 03 November 2018, ciy947. https://doi.org/10.1093/cid/ciy947