Clinical Application of Bacteriophage Therapy in Children

Bacteriophages are highly specific in targeting single pathogens in the treatment of bacterial infections and thus offer a promising alternative to antibiotic therapies with the potential for essentially no impact to the child's own microbiome. Bacteriophages have been evaluated by investigators for several pathogens and tissue site infections in adults, but data in children are lacking. The application of this therapy in pediatrics provides an extraordinary opportunity to redesign our approach to directed, precision medicine antimicrobial therapy for infants and children for both acute infections and for chronic infections, particularly those caused by multidrug-resistant pathogens. In this therapeutic approach, a bacteriophage preparation would be selected exclusively for and limited to the patient's specific pathogen, thus minimizing the collateral damage to the child's microbiome, as often demonstrated with antibiotic therapy. In the following article, we describe these novel anti-infective biological agents, review the recent literature, discuss practical considerations and limitations, and share potential applications for both topical and systemic administration of bacteriophages, either as primary therapy or in combination with traditional antibiotics. Additionally, important areas of interest for pediatric research are discussed.