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Controlled Clinical Trial
. 2023 Feb 10;15(2):499.
doi: 10.3390/v15020499.

Short-Term Outcomes of Phage-Antibiotic Combination Treatment in Adult Patients with Periprosthetic Hip Joint Infection

Eugeny Fedorov  1 , Alexander Samokhin  2 , Yulia Kozlova  3 , Svetlana Kretien  1 , Taalai Sheraliev  1 , Vera Morozova  3 , Nina Tikunova  3 , Alexey Kiselev  4 , Vitaliy Pavlov  1
Affiliations
Controlled Clinical Trial

Short-Term Outcomes of Phage-Antibiotic Combination Treatment in Adult Patients with Periprosthetic Hip Joint Infection

Eugeny Fedorov et al. Viruses. .

Abstract

Implant-associated infections are the most costly problem in modern orthopedics due to the continued increase in the occurrence of antibiotic-resistant bacterial strains that requires the development of new effective antimicrobials. A non-randomized, prospective, open-label, with historical control study on the use of combined phage/antibiotic therapy of periprosthetic joint infection (PJI) was carried out. Forty-five adult patients with deep PJI of the hip joint were involved in the study, with a 12-month follow-up after one-stage revision surgery. Patients from a prospective study group (SG, n = 23) were treated with specific phage preparation and etiotropic antibiotics, whereas patients from a retrospective comparator group (CG, n = 22) received antibiotics only. The rate of PJI relapses in the SG was eight times less than that in the CG: one case (4.5%) versus eight cases (36.4%), p = 0.021. The response rate to treatment was 95.5% (95% confidence interval (CI) = 0.7511-0.9976) in the SG and only 63.6% (95% CI = 0.4083-0.8198) in the CG. The odds ratio for PJI relapse in patients of the SG was 0.083 (95% CI = 0.009-0.742), which was almost 12 times lower than that in the CG. The obtained results support the efficacy of the combined phage-antibiotic treatment of PJI.

Keywords: PJI; antibiotics; hip joint infection; orthopedics; periprosthetic; phage therapy; surgery.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study design and patient disposition.
Figure 2
Figure 2
Diagnostic and treatment protocol of combined phage and antibiotic PJI treatment.
Figure 3
Figure 3
C-reactive protein concentration during PJI treatment for 12 ± 2 days after surgery (ITT population). Note: whiskers are based on 1.5 interquartile range, circles and asterisks are outliers.
Figure 4
Figure 4
ESR values during PJI treatment for 12 ± 2 days after surgery (ITT population). Note: whiskers are based on 1.5 interquartile range, circles are outliers.
See this image and copyright information in PMC

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