Effective therapeutic options for melioidosis: Antibiotics versus phage therapy

Lim, Yue-Min and Vadivelu, Jamuna and Mariappan, Vanitha and Venkatraman, Gopinath and Vellasamy, Kumutha Malar (2023) Effective therapeutic options for melioidosis: Antibiotics versus phage therapy. Pathogens, 12 (1). ISSN 2076-0817, DOI https://doi.org/10.3390/pathogens12010011.

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Melioidosis, also known as Whitmore's disease, is a potentially fatal infection caused by the Gram-negative bacteria Burkholderia pseudomallei with a mortality rate of 10-50%. The condition is a ``glanders-like'' illness prevalent in Southeast Asian and Northern Australian regions and can affect humans, animals, and sometimes plants. Melioidosis received the epithet ``the great mimicker'' owing to its vast spectrum of non-specific clinical manifestations, such as localised abscesses, septicaemia, pneumonia, septic arthritis, osteomyelitis, and encephalomyelitis, which often lead to misdiagnosis and ineffective treatment. To date, antibiotics remain the backbone of melioidosis treatment, which includes intravenous therapy with ceftazidime or meropenem, followed by oral therapy with TMP-SMX or amoxicillin/clavulanic acid and supported by adjunctive treatment. However, bacteria have developed resistance to a series of antibiotics, including clinically significant ones, during treatment. Therefore, phage therapy has gained unprecedented interest and has been proposed as an alternative treatment. Although no effective phage therapy has been published, the findings of experimental phage therapies suggest that the concept could be feasible. This article reviews the benefits and limitations of antibiotics and phage therapy in terms of established regimens, bacterial resistance, host specificity, and biofilm degradation.

Item Type: Article
Funders: Universiti Malaya under the Impact Oriented Interdisciplinary Research Grant (IIRG), IIRG019A-2019
Uncontrolled Keywords: Melioidosis; Burkholderia pseudomallei; Phage therapy; Antibiotics; Antibiotics resistance
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Medicine
Depositing User: Ms Zaharah Ramly
Date Deposited: 16 Nov 2023 05:16
Last Modified: 16 Nov 2023 05:16
URI: http://eprints.um.edu.my/id/eprint/39038

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