Bacteriophages and related endolysins for reduction of microorganisms in the human body - a systematic review.
Level 1 - systematic review of randomized trials
Systematic review including randomized controlled trials and observational studies
PubMed 35111563 · doi:10.3205/dgkh000404
What was done
Authors conducted a systematic review searching MEDLINE, EMBASE, Web of Science, and CENTRAL for clinical evaluations of bacteriophage therapy or endolysins in patients with bacterial infections. Studies were screened against inclusion and exclusion criteria, and data regarding patient outcomes and safety were extracted from eligible publications.
What was found
Thirteen publications met inclusion criteria. Three out of four randomized controlled trials showed no statistically significant difference in outcomes between phage/endolysin-treated patients and control groups. In contrast, cohort and case studies reported significant clinical improvements and reductions in inflammatory mediators. Across reviewed studies, infections and target bacteria were rarely completely eradicated, and only a few minor side effects were reported. Specific quantitative effect sizes and patient counts were not reported in the abstract.
Why it matters
This review highlights a substantial discrepancy between promising observational reports and neutral randomized controlled trials, indicating that bacteriophage therapies require more rigorous testing before they can be considered reliable alternatives to standard antibiotics.
Limits
The abstract reports no numerical effect sizes, meta-analytic statistics, or total patient counts. The overall evidence base is limited to 13 studies with only four randomized trials, and complete microbiological eradication was rarely demonstrated.
Cited by
- supports Bacteriophages are viruses that specifically infect and attack bacteria and do not infect humans, mammals, or eukaryotic cells.