Bacteriophage Therapy As An Alternative To Antibiotics: A Meta-Analysis

Background: The rise of antimicrobial resistance has driven the search for alternative therapies. Bacteriophage (phage) therapy, which employs viruses to target specific bacterial pathogens, is regaining attention as a promising solution for multidrug-resistant (MDR) infections. Objective: This meta-analysis aims to evaluate the clinical efficacy, safety, and treatment outcomes associated with phage therapy in managing MDR bacterial infections. Methods: A systematic review and meta-analysis were conducted using data from observational studies and case reports published between 2000 and early 2025. Eligible studies included human subjects treated with phage therapy for laboratory-confirmed MDR infections. Data were extracted on clinical outcomes, adverse events, phage characteristics, and concurrent antibiotic use. Risk of bias was assessed using the ROBINS-I tool for observational studies and the Joanna Briggs Institute (JBI) checklist for case reports. A random-effects model was used to calculate pooled cure rates and assess heterogeneity. Results: Eight studies involving 196 patients were included in the meta-analysis. The pooled clinical cure rate was 71% (95% CI: 0.59–0.81), with moderate heterogeneity (I² = 44.4%). The highest efficacy was observed in studies targeting complex infections like prosthetic joint infections and osteomyelitis. Adverse events were rare and generally mild. Case reports also showed a favorable safety profile and microbiological clearance in 8 out of 9 patients. Conclusion: Bacteriophage therapy demonstrates substantial clinical promise as an adjunct or alternative to antibiotics for MDR infections. Despite limitations related to study design and heterogeneity, these findings support the integration of phage therapy into clinical practice and highlight the need for standardized protocols and randomized controlled trials.