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The Journal of clinical investigation
Mar 03, 2025;135 (5):

Bacteriophage therapy for multidrug-resistant infections: current technologies and therapeutic approaches.

Minyoung Kevin Kim, Gina A Suh, Grace D Cullen, Saumel Perez Rodriguez, Tejas Dharmaraj, Tony Hong Wei Chang, Zhiwei Li, Qingquan Chen, Sabrina I Green, Rob Lavigne, Jean-Paul Pirnay, Paul L Bollyky, Jessica C Sacher
Author Information
  1. Minyoung Kevin Kim: Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, California, USA.
  2. Gina A Suh: Division of Public Health, Infectious Diseases and Occupational Health, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
  3. Grace D Cullen: Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, California, USA.
  4. Saumel Perez Rodriguez: Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, California, USA.
  5. Tejas Dharmaraj: Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, California, USA.
  6. Tony Hong Wei Chang: Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, California, USA.
  7. Zhiwei Li: Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, California, USA.
  8. Qingquan Chen: Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, California, USA.
  9. Sabrina I Green: Laboratory of Gene Technology, Department of Biosystems, KU Leuven, Leuven, Belgium.
  10. Rob Lavigne: Laboratory of Gene Technology, Department of Biosystems, KU Leuven, Leuven, Belgium.
  11. Jean-Paul Pirnay: Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium.
  12. Paul L Bollyky: Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, California, USA.
  13. Jessica C Sacher: Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, California, USA.
PMID: 40026251 DOI: 10.1172/JCI187996

Abstract

Bacteriophage (phage) therapy has emerged as a promising solution to combat the growing crisis of multidrug-resistant (MDR) infections. There are several international centers actively engaged in implementation of phage therapy, and recent case series have reported encouraging success rates in patients receiving personalized, compassionate phage therapy for difficult-to-treat infections. Nonetheless, substantial hurdles remain in the way of more widespread adoption and more consistent success. This Review offers a comprehensive overview of current phage therapy technologies and therapeutic approaches. We first delineate the common steps in phage therapy development, from phage bank establishment to clinical administration, and examine the spectrum of therapeutic approaches, from personalized to fixed phage cocktails. Using the framework of a conventional drug development pipeline, we then identify critical knowledge gaps in areas such as cocktail design, formulation, pharmacology, and clinical trial design. We conclude that, while phage therapy holds promise, a structured drug development pipeline and sustained government support are crucial for widespread adoption of phage therapy for MDR infections.

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MeSH Term

Humans
Phage Therapy
Drug Resistance, Multiple, Bacterial
Bacterial Infections
Bacteriophages
Journal Article Review
Article has an altmetric score of 30

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