Phage and Endolysin Therapy Against Antibiotics Resistant Bacterial Otitis and Rhinosinusitis: A Narrative Review on In Vivo and In Vitro Applications

Chronic otitis media (OM) and chronic rhinosinusitis (CRS) are common inflammatory diseases affecting many people worldwide. Effectively eliminating the causative pathogens is critical in managing these conditions. A multifactorial disease process involving bacteria is thought to drive the inflammation in OM and CRS. When selecting antibiotic treatments for these diseases, understanding their distinctive microbiology is important. Bacterial infection, biofilm formation, obstructed ventilation, and inflammation are key factors contributing to treatment failure in OM and CRS. High antibiotic resistance, particularly in multidrug-resistant (MDR) isolates and biofilms, has rendered many antibiotics ineffective in preventing OM and CRS infections. Therefore, exploring creative solutions like phage therapy has garnered significant attention. Phages are biological agents with antibacterial and anti-biofilm properties that hold promise for improving the management of these recalcitrant infections. Accumulating evidence from studies investigating phages’ effects on OM and CRS in laboratory conditions, ex vivo, animal models, and human patients shows that phages can be potential therapeutic agents for targeting infections and biofilms. However, further investigations are needed to fully explore all aspects of phage therapy, including accurate identification of the causative microorganisms and more detailed characterization of the biofilms involved.