title: Recent advances in bacteriophage therapy: how delivery routes, formulation, concentration and timing influence the success of phage therapy.
abstract: OBJECTIVE
  Bacteriophages are bacteria-specific viruses that infect and, in the case of obligately lytic phages, destroy their host bacteria. Phage therapy has been used therapeutically to combat bacterial infections since their discovery. This paper reviewed recent in-vivo phage therapy studies, with a distinct focus on the effect of delivery routes, phage concentration and timing of administration on the success of the therapy.
  
  
  RESULTS
  It was found that the most successful route of administration for the treatment of systemic infections was via the parenteral route. Oral delivery is mainly used to treat gastrointestinal infections. However, in some cases phages can also reach the systemic circulation. Local delivery (skin, ears, teeth) has proved extremely successful in the treatment of topical infections, as has the inhalation of phages for the treatment of lung infections. The ability of phages to prevent biofilm formation on medical devices has received much attention, mainly in the area of catheter coatings. This review also highlights areas in which phage therapy needs substantial development. Many papers were lacking in formulation details, with crude phage stocks being used in most cases. No phage stability data were included in any of the papers.
  
  
  CONCLUSIONS
  The review concluded that although phage therapy is an excellent alternative for the treatment of bacterial infections, optimisation of formulations and long-term stability data is required before it can be widely used within a clinical setting.
authors: School of Pharmacy, Queens University Belfast, Belfast, UK.
authors: Elizabeth M
authors: EM
authors: Ryan
authors: Sean P
authors: SP
authors: Gorman
authors: Ryan F
authors: RF
authors: Donnelly
authors: Brendan F
authors: BF
authors: Gilmore
mesh_terms: D000818:Animals; D001424:Bacterial Infections / Q000628:therapy*; D001435:Bacteriophages; D018441:Biofilms / Q000254:growth & development; D001691:Biological Therapy / Q000379:methods; D004333:Drug Administration Routes; D004334:Drug Administration Schedule; D004864:Equipment and Supplies / Q000382:microbiology; D006801:Humans