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. 2023 Dec 12;11(6):e0290723.
doi: 10.1128/spectrum.02907-23. Epub 2023 Oct 11.

Stability of magistral phage preparations before therapeutic application in patients with chronic rhinosinusitis, sepsis, pulmonary, and musculoskeletal infections

Saartje Uyttebroek #  1   2 , Laura Bessems #  3   4 , Willem-Jan Metsemakers  3   4 , Yves Debaveye  5   6 , Laura Van Gerven  1   2   7 , Lieven Dupont  8   9 , Melissa Depypere  10   11 , Jeroen Wagemans  12 , Rob Lavigne  12 , Maya Merabishvili  13 , Jean-Paul Pirnay  13 , David Devolder  14 , Isabel Spriet #  14   15 , Jolien Onsea #  3   4
Affiliations

Stability of magistral phage preparations before therapeutic application in patients with chronic rhinosinusitis, sepsis, pulmonary, and musculoskeletal infections

Saartje Uyttebroek et al. Microbiol Spectr. .

Abstract

As antimicrobial resistance becomes more prevalent, the application of (bacterio)phage therapy as an alternative treatment for difficult-to-treat infections is (re)gaining popularity. Over the past decade, numerous promising case reports and series have been published demonstrating the therapeutic potential of phage therapy. However, important questions remain regarding the optimal treatment protocol and, unlike for medicinal products, there are currently no predefined quality standards for the stability of phage preparations. Phage titers can be influenced by several factors which could lead to reduced titers after preparation and storage and, ultimately, subtherapeutic applications. Determining the stability of different phages in different recipients according to the route of administration is therefore one of the first important steps in establishing a standardized protocol for phage therapy.

Keywords: bacteriophages; formulation; phage therapy; phages; stability.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig 1
Fig 1
Phage therapy flow in the PHAGEFORCE project: from magistral phage preparation to standardized treatment protocols. Figure created with Biorender.com. QAMH: Queen Astrid Military Hospital, UZ Leuven: University Hospitals Leuven, API: active pharmaceutical ingredient, DPBS: Dulbecco’s phosphate-buffered saline, PFU: plaque-forming units.
Fig 2
Fig 2
Repeated phage titers with mean and standard deviation for CRS (A), MSI (B), sepsis (C), and CF/Bx (D). PFU: plaque-forming units.
Fig 3
Fig 3
(A) Mechanical test for CRS with baseline titer (T-1), titer after irrigation (T0) and titer after 1 h at room temperature. (B) Mechanical test for sepsis with baseline titer (T0) and titer after infusion through a three-lumen catheter (T1). PFU: plaque-forming units.
Fig 4
Fig 4
Number of phages (PFU/mL) in the initial phage solution (baseline) and attached to the 50 mL polypropylene syringe after three rounds of washing with Tween 20. PFU: plaque-forming units.
See this image and copyright information in PMC

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