Phage Therapy in Orthopaedic Implant-Associated Infections

Implant-associated infection (IAI) remains a significant issue in orthopaedic surgery. Bacteriophages are naturally occurring viruses that kill bacteria. Bacteriophages are being considered as a reliable alternative and/or adjunct to antibiotics, especially with the rise of multidrug-resistant bacterial strains. The isolation of bacteriophages from the environment against major bacterial pathogens may be easier than searching for new antibiotics against these virulent bacterial stains. Although bacteriophages are not pathogenic to mammalian cells, they induce a humoral immune response in a mammalian host resulting in the formation of anti-phage antibodies that can influence the effect of phage therapy. We detail the experiences of several centers in Poland, the Republic of Georgia, the Russian Federation, and France that have extensive experience with phage therapy for IAI. Phage therapy is an emerging new paradigm for the treatment of IAI as multidrug-resistant bacteria become more common and national governments as well as global health agencies push to improve antibiotic stewardship in clinical practice.