How to: assess patient suitability for unlicensed phage therapy in the United Kingdom.

Bacteriophage United Kingdom phage therapy

Journal

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420

Informations de publication

Date de publication:
05 Aug 2024
Historique:
received: 29 03 2024
revised: 05 07 2024
accepted: 18 07 2024
medline: 8 8 2024
pubmed: 8 8 2024
entrez: 7 8 2024
Statut: aheadofprint

Résumé

Bacteriophage (phage) therapy is a promising alternative antimicrobial approach which has the potential to transform the way we treat bacterial infections. The antibiotic resistance crisis is driving renewed interest in phage therapy. There are currently no licenced phage therapy medicinal products and phage therapy is used in small but growing patient numbers on an unlicensed basis. This article provides guidelines on the assessment of patient suitability for unlicensed phage therapy for clinicians in the United Kingdom. This article builds on Health Improvement Scotland's recommendation for the consideration of phage therapy in difficult-to-treat infection and the experience of the author group who have collectively assessed the suitability of 30 patients for phage therapy. In the UK, unlicensed medicines, including phages, may be considered to meet special clinical needs. The use of unlicensed medicines is governed by national legislation and local NHS Trust policies. Phages can be used in any NHS Trust and decisions about suitability should be made via existing local clinical management pathways. This article sets out guidelines to support local clinical teams in the assessment of patient suitability for phage therapy. Clinical and microbiological considerations are presented, including allergy and pregnancy.

Sections du résumé

BACKGROUND BACKGROUND
Bacteriophage (phage) therapy is a promising alternative antimicrobial approach which has the potential to transform the way we treat bacterial infections. The antibiotic resistance crisis is driving renewed interest in phage therapy. There are currently no licenced phage therapy medicinal products and phage therapy is used in small but growing patient numbers on an unlicensed basis.
OBJECTIVES OBJECTIVE
This article provides guidelines on the assessment of patient suitability for unlicensed phage therapy for clinicians in the United Kingdom.
SOURCES METHODS
This article builds on Health Improvement Scotland's recommendation for the consideration of phage therapy in difficult-to-treat infection and the experience of the author group who have collectively assessed the suitability of 30 patients for phage therapy.
CONTENT BACKGROUND
In the UK, unlicensed medicines, including phages, may be considered to meet special clinical needs. The use of unlicensed medicines is governed by national legislation and local NHS Trust policies. Phages can be used in any NHS Trust and decisions about suitability should be made via existing local clinical management pathways. This article sets out guidelines to support local clinical teams in the assessment of patient suitability for phage therapy. Clinical and microbiological considerations are presented, including allergy and pregnancy.

Identifiants

pubmed: 39111698
pii: S1198-743X(24)00355-0
doi: 10.1016/j.cmi.2024.07.022
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Competing interests JDJ is Director of the company UK Phage Therapy. All other authors declare no competing interests.

Auteurs

Joshua D Jones (JD)

Infection Medicine, Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK. Electronic address: josh.jones@ed.ac.uk.

Helen J Stacey (HJ)

Public Health, Kings Cross Hospital, Clepington Road, Dundee, DD3 8EA, UK.

John W Kennedy (JW)

Department of Trauma and Orthopaedics, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, G51 4TF, UK.

Maya Merabishvilli (M)

Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium.

Melissa E K Haines (MEK)

Leicester Centre for Phage Research, Department of Genetics and Genome Biology, University of Leicester, Leicester, LE1 7RH, UK.

Oliver Blocker (O)

Department of Trauma and Orthopaedics, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, LL57 2PW, UK.

Kumara Dharmasena (K)

Department of Microbiology, Great Western Hospitals NHS Foundation Trust, Swindon, UK.

Andrew Gordon (A)

Department of Orthopaedics, The Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Herries Road, Sheffield, S5 7AU, UK.

Stuart A Hamilton (SA)

Department of Plastic Surgery, St John's Hospital, Howden W Rd, Howden, Livingston EH54 6PP, UK.

Ila Aggarwal (I)

Department of Microbiology, Ninewells Hospital, DD1 9SY, Dundee, UK.

John Nagy (J)

Department of Vascular Surgery, Ninewells Hospital, DD1 9SY, Dundee, United Kingdom.

Don S Urquhart (DS)

Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Children and Young People, Edinburgh, EH16 4TJ, UK; Department of Child Life and Health, University of Edinburgh, Royal Hospital for Children and Young People, 50 Little France Crescent, Edinburgh BioQuarter, Edinburgh, EH16 4TJ, UK.

Lesley M L Hall (LML)

Department of Diabetes and Endocrinology, Queen Elizabeth University Hospital, 1345 Govan Road, Govan, Glasgow, G51 4TF, UK.

Matthew J Young (MJ)

Diabetes Foot Clinic, Outpatient Department 2, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK.

Gordon MacGregor (G)

Department of Respiratory Medicine, Queen Elizabeth University Hospital, NHS GGC, Glasgow, G51 4TF, UK.

Ross J Langley (RJ)

Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, UK; School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, G12 8QQ, UK.

Christine Peters (C)

Department of Microbiology, Queen Elizabeth University Hospital, NHS GGC, Glasgow, G51 4TF, UK.

Daniela I Munteanu (DI)

Department of Microbiology, Ninewells Hospital, DD1 9SY, Dundee, UK. Electronic address: daniela.munteanu@nhs.scot.

Classifications MeSH