A theoretical exploration of protocols for treating prosthetic joint infections with combinations of antibiotics and bacteriophage

With the increase in the placement of prosthetic joints and other hardware in the body, associated infections have risen. These infections are complicated to treat due to the underlying bacteria generating matrices that resist clearance by immune system effectors or antibiotics. These matrices, biofilms, have two primary ways of being eradicated: either by physical removal during surgery or by killing the underlying bacteria, usually with antibiotics. The viruses that kill bacteria, bacteriophages, are readily capable of entering biofilms and eradicating the bacteria therein. Therefore, bacteriophages have therapeutic potential as a supplement to antibiotics for the treatment of prosthetic joint infections. In this investigation, we generate a mathematical and computer-simulation model to explore the contributions of the innate immune system with antibiotics, bacteriophage, and the joint action to control biofilm-associated infections. Our results question the proposition that bacteriophages are an effective addition in the treatment of prosthetic joint infections.