Refractory Pseudomonas aeruginosa infections treated with phage PASA16 : A compassionate use case series

Copyright © 2023 Elsevier Inc. All rights reserved..

BACKGROUND: A growing number of compassionate phage therapy cases were reported in the last decade, with a limited number of clinical trials conducted and few unsuccessful clinical trials reported. There is only a little evidence on the role of phages in refractory infections. Our objective here was to present the largest compassionate-use single-organism/phage case series in 16 patients with non-resolving Pseudomonas aeruginosa infections.

METHODS: We summarized clinical phage microbiology susceptibility data, administration protocol, clinical data, and outcomes of all cases treated with PASA16 phage. In all intravenous phage administrations, PASA16 phage was manufactured and provided pro bono by Adaptive Phage Therapeutics. PASA16 was administered intravenously, locally to infection site, or by topical use to 16 patients, with data available for 15 patients, mainly with osteoarticular and foreign-device-associated infections.

FINDINGS: A few minor side effects were noted, including elevated liver function enzymes and a transient reduction in white blood cell count. Good clinical outcome was documented in 13 out of 15 patients (86.6%). Two clinical failures were reported. The minimum therapy duration was 8 days with a once- to twice-daily regimen.

CONCLUSIONS: PASA16 with antibiotics was found to be relatively successful in patients for whom traditional treatment approaches have failed previously. Such pre-phase-1 cohorts can outline potential clinical protocols and facilitate the design of future trials.

FUNDING: The study was funded in part by The Israeli Science Foundation IPMP (ISF_1349/20), Rosetrees Trust (A2232), United States-Israel Binational Science Foundation (2017123), and the Milgrom Family Support Program.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:4

Enthalten in:

Med (New York, N.Y.) - 4(2023), 9 vom: 08. Sept., Seite 600-611.e4

Sprache:

Englisch

Beteiligte Personen:

Onallah, Hadil [VerfasserIn]
Hazan, Ronen [VerfasserIn]
Nir-Paz, Ran [VerfasserIn]
PASA16 study group [VerfasserIn]
Brownstein, Michael J [VerfasserIn]
Fackler, Joseph R [VerfasserIn]
Horne, Bri'Anna [VerfasserIn]
Hopkins, Robert [VerfasserIn]
Basu, Subhendu [VerfasserIn]
Yerushalmy, Ortal [VerfasserIn]
Alkalay-Oren, Sivan [VerfasserIn]
Braunstein, Ron [VerfasserIn]
Rimon, Amit [VerfasserIn]
Gelman, Daniel [VerfasserIn]
Khalifa, Leron [VerfasserIn]
Adler, Karen [VerfasserIn]
Abdalrhman, Mohanad [VerfasserIn]
Gelman, Shira [VerfasserIn]
Katvan, Eyal [VerfasserIn]
Coppenhagen-Glazer, Shunit [VerfasserIn]
Moses, Allon [VerfasserIn]
Oster, Yonatan [VerfasserIn]
Dekel, Michal [VerfasserIn]
Ben-Ami, Ronen [VerfasserIn]
Khoury, Amal [VerfasserIn]
Kedar, Daniel J [VerfasserIn]
Meijer, Suzy E [VerfasserIn]
Ashkenazi, Itay [VerfasserIn]
Bishouty, Nancy [VerfasserIn]
Yahav, Dafna [VerfasserIn]
Shostak, Eran [VerfasserIn]
Livni, Gilat [VerfasserIn]
Paul, Mical [VerfasserIn]
Gross, Menachem [VerfasserIn]
Ormianer, Matityahou [VerfasserIn]
Aslam, Saima [VerfasserIn]
Ritter, Michele [VerfasserIn]
Urish, Kenneth L [VerfasserIn]
La Hoz, Ricardo M [VerfasserIn]
Khatami, Ameneh [VerfasserIn]
Britton, Philip N [VerfasserIn]
Lin, Ruby C Y [VerfasserIn]
Iredell, Jonathan R [VerfasserIn]
Petrovic-Fabijan, Aleksandra [VerfasserIn]
Lynch, Stephanie [VerfasserIn]
Tamma, Pranita D [VerfasserIn]
Yamshchikov, Alexandra [VerfasserIn]
Lesho, Emil [VerfasserIn]
Morales, Megan [VerfasserIn]
Werzen, Alissa [VerfasserIn]
Saharia, Kapil [VerfasserIn]

Links:

Volltext

Themen:

Anti-Bacterial Agents
Bacteriophage therapy
Bone and joint infections
Clinical phage microbiology
Journal Article
Persistant infections
Phage therapy
Pseudomonas aeruginosa
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Resistant infections
Translation to patients

Anmerkungen:

Date Completed 11.09.2023

Date Revised 03.10.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.medj.2023.07.002

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM360619762