{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:22:13Z","timestamp":1790727733499,"version":"4.1.0"},"reference-count":64,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,11,10]],"date-time":"2020-11-10T00:00:00Z","timestamp":1604966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MC_PC_18046"],"award-info":[{"award-number":["MC_PC_18046"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004744","name":"Innoviris","doi-asserted-by":"publisher","award":["PhD scholarship funding"],"award-info":[{"award-number":["PhD scholarship funding"]}],"id":[{"id":"10.13039\/501100004744","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Bacterial resistance to antibiotics has catalysed interest in alternative antimicrobial strategies. Bacteriophages (phages) are viruses of bacteria with a long history of successful therapeutic use. Phage therapy is a promising antibacterial strategy for infections with a biofilm component, including recalcitrant bone and joint infections, which have significant social, financial and human impacts. Here, we report a systematic review of the safety and efficacy of phage therapy for the treatment of bone and joint infections. Three electronic databases were systematically searched for articles that reported primary data about human phage therapy for bone and joint infections. Two authors independently assessed study eligibility and performed data extraction. Seventeen reports were eligible for inclusion in this review, representing the treatment of 277 patients. A cautionary, crude, efficacy estimate revealed that 93.1% (n = 258\/277) achieved clinical resolution, 3.3% (n = 9\/277) had improvement and 3.6% (n = 10\/277) showed no improvement. Seven of the nine reports that directly commented on the safety of phage therapy did not express safety concerns. The adverse effects reported in the remaining two were not severe and were linked to the presence of contaminating endotoxins and pre-existing liver pathology in a patient treated with high-titre intravenous phage therapy. Three other reports, from 1940\u20131987, offered general comments on the safety of phage therapy and documented adverse effects consistent with endotoxin co-administration concomitant with the use of raw phage lysates. Together, the reports identified by this review suggest that appropriately purified phages represent a safe and highly efficacious treatment option for complex and intractable bone and joint infections.<\/jats:p>","DOI":"10.3390\/antibiotics9110795","type":"journal-article","created":{"date-parts":[[2020,11,10]],"date-time":"2020-11-10T14:10:41Z","timestamp":1605017441000},"page":"795","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["The Safety and Efficacy of Phage Therapy for Bone and Joint Infections: A Systematic Review"],"prefix":"10.3390","volume":"9","author":[{"given":"Alex","family":"Clarke","sequence":"first","affiliation":[{"name":"Infection Medicine, Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Chancellor\u2019s Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"De Soir","sequence":"additional","affiliation":[{"name":"Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Rue Bruyn, 1120 Brussels, Belgium"},{"name":"Cellular &amp; Molecular Pharmacology, Louvain Drug Research Institute, Universit\u00e9 Catholique de Louvain (UCLouvain), avenue E. Mounier 73, 1200 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Jones","sequence":"additional","affiliation":[{"name":"Infection Medicine, Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Chancellor\u2019s Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,10]]},"reference":[{"key":"ref_1","unstructured":"Fleming, A. (2020, November 09). Penicillin. 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