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    Phagetherapy: Clinical Applications – Critical Appraisal of Randomized Controlled Trials

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    Phagotherapy, defined as the use of bacteriophage to treat bacterial infections, was initially proposed by Felix d’Herelle, a French-Canadian who did a lot of research on this topic in Paris, but also travelled the world to treat patients in different settings and conditions. While the literature on this topic is quite extensive, the number of randomized controlled trials is rather limited. Large studies were performed and published in the former USSR republics more than 50 years ago. Since then, there were few trials performed, enrolling a limited number of patients and assessing potential phage efficacy in different settings such as chronic otitis or infected burn wounds. In this chapter, we review and discuss these different randomized trials. While the results might look disappointing at first sight, they all confirm safety of phage used for treatment of difficult clinical situations. Those trials should help define further studies in order to obtain the best possible results and hopefully confirm that phages could be used as an alternative to treat difficult to treat multi-drug-resistant bacterial infections
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