Potential of Inhaled Bacteriophage Therapy for Bacterial Lung Infection

Abstract

Phage therapy as a promising alternative antimicrobial to treat multidrug resistant (MDR) bacteria related lung infections, has drawn significant attention in clinical trials and bench-scale study in the recent decade, and the therapeutic effect of local delivery of phage has been demonstrated by several clinical reports. This book chapter discusses the current clinical development of inhaled phage therapy followed by the advancement of phage formulation designs for respiratory delivery of phage using various inhalation devices and their in vivo efficacy. The development of combination therapy of phage and antibiotics to combat MDR bacteria associated lung infections is also covered to reflect the current clinical practice. Lastly, we also share our insights on the challenges of advancing inhaled phage therapy and potential directions for future research.

Prospects of Inhaled Phage Therapy for Combatting Pulmonary Infections

“…As freeze-dried powders are not respirable, after their production an extra milling step is required to reduce the particle size to <5 μm, which is ideal for pulmonary delivery. However, this milling process may cause loss of phage due to the mechanical stress produced ( Yan et al., 2021 ). Golshahi et al.…”

“…As freeze-dried powders are not respirable, after their production an extra milling step is required to reduce the particle size to <5 mm, which is ideal for pulmonary delivery. However, this milling process may cause loss of phage due to the mechanical stress produced (Yan et al, 2021). Golshahi et al (2011) prepared endotoxin-free lyophilized formulations of KS4-M and FKZ phages with 60% lactose and 40% lactoferrin as the selected cryo-protectant and stabilizers and then de-agglomerated in a mixer mill (without beads) to formulate respirable powders and aerosolized using an Aerolizer ® capsule inhaler.…”