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Bakteriophagen zur Behandlung muskuloskelettaler Infektionen – Eine Übersicht zu klinischem Einsatz, offenen Fragen und rechtlichem Rahmen.
Bacteriophages for the treatment of musculoskeletal infections-An overview of clinical use, open questions, and legal framework.
Orthopadie, DOI: 10.1007/s00132-025-04690-z (2025)
BACKGROUND: Bacteriophages, or simply phages, are viruses that specifically infect and lyse bacteria. As antibiotic resistance becomes a growing global concern, phage therapy is gaining renewed attention as a targeted and effective treatment option. In orthopedics and trauma surgery-disciplines characterized by high rates of chronic and implant-associated infections-phages offer promising new therapeutic avenues, particularly in cases involving multidrug-resistant pathogens or when conventional surgery is limited. CURRENT DEVELOPMENTS: Originally developed in the early 20th century, phage therapy lost prominence with the rise of antibiotics. Today, case studies and emerging clinical protocols-especially in the context of periprosthetic joint infections-demonstrate the potential of personalized phage cocktails and advanced delivery systems, such as hydrogels or intra-articular injections. Their specificity enables bacterial eradication while sparing the host microbiome. REGULATORY SITUATION: However, the regulatory landscape in the European Union poses significant challenges. Phages are classified as biological medicinal products, requiring comprehensive preclinical and clinical evaluation. While magistral production and compassionate use permit individual applications, broad clinical integration demands standardized protocols, accessible phage libraries, and robust quality control. Furthermore, safety concerns, including immunogenicity and systemic distribution, must be addressed through structured research. CONCLUSION: To fully realize the potential of phage therapy in orthopaedic infection management, interdisciplinary collaboration, targeted funding, and clinical trials are essential. Responsible implementation within expert centers can ensure efficacy and safety, paving the way for a controlled and evidence-based adoption of phages as a complementary strategy alongside traditional surgical and antibiotic treatments.
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Publication type
Article: Journal article
Document type
Review
Keywords
Antibiotics ; Endoprosthesis ; Multidrug Resistance ; Periprosthetic Joint Infection ; Phage Therapy; Phage Therapy
Language
german
Publication Year
2025
HGF-reported in Year
2025
ISSN (print) / ISBN
2731-7145
e-ISSN
2731-7153
Journal
Die Orthopädie
Publisher
Springer
Publishing Place
One New York Plaza, Suite 4600, New York, Ny, United States
Reviewing status
Peer reviewed
Institute(s)
Institute of Virology (VIRO)
POF-Topic(s)
30203 - Molecular Targets and Therapies
Research field(s)
Immune Response and Infection
PSP Element(s)
G-554300-001
Grants
Projekt DEAL
WOS ID
001542012200001
Scopus ID
105012280654
PubMed ID
40745494
Erfassungsdatum
2025-10-02