“…Strategies to enhance stability of phages at unfavorable pH or temperatures and avoid phage elimination from the body to maintain active phages at infective doses are being pursued (e.g., encapsulation of phages in various matrices) ( 199 ). To date, phages have been detected in blood, urine, and feces in a dose-dependent manner in animal models following oral phage administration ( 200 , 201 ). However, recovery of phages was inconsistent and, in some cases, not detectable in blood ( 202 ).…”
Section: Question 14: What Are Potential Routes Of Administration For...mentioning
Increasing antimicrobial resistance and medical device-related infections have led to a renewed interest in phage therapy as an alternative or adjunct to conventional antimicrobials. Expanded access and compassionate use cases have risen exponentially but have varied widely in approach, methodology, clinical situations in which phage therapy might be considered, dosing, route of administration, and outcomes. Large gaps in knowledge contribute to a heterogeneity in approach and lack of clear consensus in many important clinical areas. Here, the Antibacterial Resistance Leadership Group (ARLG) has convened a panel of experts in phage therapy, clinical microbiology, infectious diseases, and pharmacology, who worked with regulatory experts and a funding agency to identify questions based on a clinical framework and divided them into three themes: potential clinical situations in which phage therapy might be considered, and laboratory testing and pharmacokinetic considerations. Suggestions are provided as answers to a series of questions intended to inform clinicians considering experimental phage therapy for patients in their clinical practices.
“…Strategies to enhance stability of phages at unfavorable pH or temperatures and avoid phage elimination from the body to maintain active phages at infective doses are being pursued (e.g., encapsulation of phages in various matrices) ( 199 ). To date, phages have been detected in blood, urine, and feces in a dose-dependent manner in animal models following oral phage administration ( 200 , 201 ). However, recovery of phages was inconsistent and, in some cases, not detectable in blood ( 202 ).…”
Section: Question 14: What Are Potential Routes Of Administration For...mentioning
Increasing antimicrobial resistance and medical device-related infections have led to a renewed interest in phage therapy as an alternative or adjunct to conventional antimicrobials. Expanded access and compassionate use cases have risen exponentially but have varied widely in approach, methodology, clinical situations in which phage therapy might be considered, dosing, route of administration, and outcomes. Large gaps in knowledge contribute to a heterogeneity in approach and lack of clear consensus in many important clinical areas. Here, the Antibacterial Resistance Leadership Group (ARLG) has convened a panel of experts in phage therapy, clinical microbiology, infectious diseases, and pharmacology, who worked with regulatory experts and a funding agency to identify questions based on a clinical framework and divided them into three themes: potential clinical situations in which phage therapy might be considered, and laboratory testing and pharmacokinetic considerations. Suggestions are provided as answers to a series of questions intended to inform clinicians considering experimental phage therapy for patients in their clinical practices.
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