Osteoarticular prosthetic infection: how many patients are eligible for phage therapy? A French single-centre retrospective study

Abstract Background. Bone and joint infections represent a major public health issue due to their increasing prevalence, their functional prognosis and their cost to society. Phage therapy has valuable anti-biofilm properties against prosthetic joint infections (PJI). The aim of this study was to establish the proportion of patients eligible for phage therapy and to assess their clinical outcome judged against all patients presenting with PJI. Method Patients admitted for PJI in a French general hospital between 2015 and 2019 were retrospectively included. The eligibility for phage therapy was defined as complex PJI criteria according to French recommendations with no contraindications. Patients were sorted into two groups: eligible and ineligible. Results In this study, 96 patients with PJI were considered in multidisciplinary medical meetings. Of these, 44% patients (42/96) were eligible for additional phage therapy. This group of patients had a longer hospital stay (43 days vs. 18 days, p < 0.01) and a longer intravenous antibiotic therapy (17 days vs. 10 days, p = 0.02). Conclusion A large number of patients met eligibility criteria for phage therapy and treatment and follow-up is more complex. A larger epidemiological study would more accurately describe the prognosis of eligible patients.