Bacteriophage Therapy in Pediatrics: Pros & Cons

Introduction: The emergence of antimicrobial resistance and increase in side effects of antibiotic therapy has become a critical problem in modern medicine. As a rule the new antibiotics are more toxic, corresponding damages can have cumulative nature. The above-mentioned points to the necessity of optimization of the stewardship of antibiotic therapy, especially in children. Bacteriophage therapy is considered as an effective tool to improve the treatment of bacterial infections and minimalize its adverse consequences. Pediatricians’ knowledge in this area is not sufficient.

The goal of the study was to conduct a survey of the literature regarding bacteriophage therapy (BT), define its Pros and Cons.

Materials: The published literature of last twenty years was analyzed. Our own experience, exceeding more than 30 years was taken into consideration as well.

Results: Pros – the bacteriophage therapy does not cause toxicity, allergy, dysbacteriosis, it is safe and can be used even in premature babies and pregnant women, combined with all kind of medicines, it has no contraindications.

It is claimed that bacteriophages can be used effectively instead or with the antibiotics in the treatment of different bacterial infections (sepsis, gastroenteritis, dermatitis, osteomyelitis, pneumonia, urinary tract infections) caused by following agents - Proteus, Klebsiella, Escherichia, Shigella, Pseudomonas, Salmonella, Streptococcus, Staphylococcus.

Bacteriophages may have some immunomodulation abilities too.

Cons - The paucity of appropriately conducted placebo-controlled clinical trials,

Regulatory conundrum of BT.

BT (at least when bacteriophages are given PO) can induce production of anti-bacteriophage antibodies, which might decrease the efficacy of BT; In children, particularly in infants their production is less manifested.

Conclusions: BT is efficient and safe, but further investigations are needed.