Effective Therapeutic Options for Melioidosis: Antibiotics versus Phage Therapy.
Yue-Min LimJamuna VadiveluVanitha MariappanGopinath VenkatramanKumutha Malar VellasamyPublished in: Pathogens (Basel, Switzerland) (2022)
Melioidosis, also known as Whitmore's disease, is a potentially fatal infection caused by the Gram-negative bacteria Burkholderia pseudomallei with a mortality rate of 10-50%. The condition is a "glanders-like" illness prevalent in Southeast Asian and Northern Australian regions and can affect humans, animals, and sometimes plants. Melioidosis received the epithet "the great mimicker" owing to its vast spectrum of non-specific clinical manifestations, such as localised abscesses, septicaemia, pneumonia, septic arthritis, osteomyelitis, and encephalomyelitis, which often lead to misdiagnosis and ineffective treatment. To date, antibiotics remain the backbone of melioidosis treatment, which includes intravenous therapy with ceftazidime or meropenem, followed by oral therapy with TMP-SMX or amoxicillin/clavulanic acid and supported by adjunctive treatment. However, bacteria have developed resistance to a series of antibiotics, including clinically significant ones, during treatment. Therefore, phage therapy has gained unprecedented interest and has been proposed as an alternative treatment. Although no effective phage therapy has been published, the findings of experimental phage therapies suggest that the concept could be feasible. This article reviews the benefits and limitations of antibiotics and phage therapy in terms of established regimens, bacterial resistance, host specificity, and biofilm degradation.
Keyphrases
- pseudomonas aeruginosa
- type diabetes
- acute kidney injury
- rheumatoid arthritis
- cardiovascular disease
- escherichia coli
- systematic review
- coronary artery disease
- combination therapy
- intensive care unit
- cell therapy
- risk factors
- extracorporeal membrane oxygenation
- bone marrow
- acute respiratory distress syndrome
- smoking cessation