{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T03:43:45Z","timestamp":1791863025995,"version":"4.3.4"},"reference-count":79,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI22\/00323"],"award-info":[{"award-number":["PI22\/00323"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Osteoarticular infections (OAIs), including osteomyelitis, septic arthritis, prosthetic joint infections, and facture-related infections, remain a major challenge due to biofilm formation and the prevalence of multidrug-resistant (MDR) pathogens. Although OAIs are predominantly caused by Staphylococcus aureus and coagulase-negative staphylococci, the increasing incidence of MDR Gram-negative infections adds further complexity to their management. Standard approaches, combining surgery and prolonged antibiotic therapy, frequently result in recurrence and poor outcomes. Bacteriophage (phage) therapy has emerged as a promising adjunct or alternative approach, offering high host specificity, replication at the infection site, and activity against biofilm-embedded bacteria. This review highlights recent advances in phage therapy for OAIs, focusing on administration routes (intravenous, intra-articular, topical, and oral) and on novel pharmaceutical delivery systems such as hydrogels, bone cements, microparticles, nanoparticles, and implant coatings. Preclinical and early clinical studies have analyzed phage stability, controlled release, and the synergistic effects of combined phage\/antibiotic therapy. However, challenges remain regarding standardization, immunogenicity, and regulatory approval. Nonetheless, phage therapy shows promise for clinical translation as an adjunct or alternative to conventional treatments for OAIs. Well-designed clinical trials are urgently needed to confirm the efficacy of phage therapy, optimize delivery strategies, and integrate the treatments in routine practice. Despite encouraging outcomes for a successful clinical implementation, regulation and standardization of GMP production are required.<\/jats:p>","DOI":"10.3390\/antibiotics14121187","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T14:17:23Z","timestamp":1763734643000},"page":"1187","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Phage Therapy for Bone and Joint Infections: Towards Clinical Translation"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6632-1454","authenticated-orcid":false,"given":"Concha","family":"Ortiz-Cartagena","sequence":"first","affiliation":[{"name":"Multidisciplinary and Translational Microbiology Group (MicroTM), Biomedical Research Institute of A Coru\u00f1a (INIBIC), Microbiology Service, University Hospital of A Coru\u00f1a (CHUAC), University of A Coru\u00f1a (UDC), 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4039-4142","authenticated-orcid":false,"given":"Lucia","family":"Blasco","sequence":"additional","affiliation":[{"name":"Multidisciplinary and Translational Microbiology Group (MicroTM), Biomedical Research Institute of A Coru\u00f1a (INIBIC), Microbiology Service, University Hospital of A Coru\u00f1a (CHUAC), University of A Coru\u00f1a (UDC), 15006 A Coru\u00f1a, Spain"},{"name":"MePRAM, Proyecto de Medicina de Precisi\u00f3n Contra las Resistencias Antimicrobianas, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1846-4693","authenticated-orcid":false,"given":"In\u00e9s","family":"Bleriot","sequence":"additional","affiliation":[{"name":"Multidisciplinary and Translational Microbiology Group (MicroTM), Biomedical Research Institute of A Coru\u00f1a (INIBIC), Microbiology Service, University Hospital of A Coru\u00f1a (CHUAC), University of A Coru\u00f1a (UDC), 15006 A Coru\u00f1a, Spain"},{"name":"MePRAM, Proyecto de Medicina de Precisi\u00f3n Contra las Resistencias Antimicrobianas, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8971-3167","authenticated-orcid":false,"given":"Jaime","family":"Esteban","sequence":"additional","affiliation":[{"name":"MePRAM, Proyecto de Medicina de Precisi\u00f3n Contra las Resistencias Antimicrobianas, 28029 Madrid, Spain"},{"name":"CIBERINFEC-CIBER de Enfermedades Infecciosas, 28029 Madrid, Spain"},{"name":"Department of Clinical Microbiology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, Universidad Aut\u00f3noma de Madrid (UAM), 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4935-8754","authenticated-orcid":false,"given":"Mar\u00eda Dolores","family":"del Toro","sequence":"additional","affiliation":[{"name":"CIBERINFEC-CIBER de Enfermedades Infecciosas, 28029 Madrid, Spain"},{"name":"Division of Infectious Diseases and Microbiology, University Hospital Virgen Macarena, 41009 Seville, Spain"},{"name":"Department of Medicine, Biomedicine Institute of Sevilla, University of Sevilla, 41009 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5402-3334","authenticated-orcid":false,"given":"Jos\u00e9 Luis","family":"del Pozo","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Cl\u00ednica Universidad de Navarra, 31008 Pamplona, Spain"},{"name":"Infectious Diseases Division, Cl\u00ednica Universidad de Navarra, 31008 Pamplona, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4501-0387","authenticated-orcid":false,"given":"Mar\u00eda","family":"Tom\u00e1s","sequence":"additional","affiliation":[{"name":"Multidisciplinary and Translational Microbiology Group (MicroTM), Biomedical Research Institute of A Coru\u00f1a (INIBIC), Microbiology Service, University Hospital of A Coru\u00f1a (CHUAC), University of A Coru\u00f1a (UDC), 15006 A Coru\u00f1a, Spain"},{"name":"MePRAM, Proyecto de Medicina de Precisi\u00f3n Contra las Resistencias Antimicrobianas, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1007\/s00590-025-04184-w","article-title":"Clinical and epidemiological differences in staphylococcal osteoarticular infections: Insights for developing hospital-based infection control interventions","volume":"35","author":"Figueiredo","year":"2025","journal-title":"Eur. 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