Patients of chronic bacterial prostatitis are often hit with a double whammy. Not only do they suffer from the morbidity associated with a chronic infection, but they also suffer because the site of the infection makes it difficult to treat with antibiotics. The prostate is a particularly difficult gland to treat when it comes to bacterial infections. Its epithelial lipid membrane only allows certain classes of antibiotics to penetrate, limiting the drugs available for treatment. This, coupled with increasingly antibiotic resistant strains of bacteria and biofilm formation, truly makes a medical practitioner’s job difficult when tackling a recurrent, chronic prostate infection. After multiple failed antibiotic treatments, the usual course to chart often becomes one of symptom management.
The Case Report – in brief
This was the predicament faced by the young male whom we have covered in our recent case report. After 5 failed courses of oral and IV antibiotics, he was advised a regimen of NSAIDs and pain killers to manage his symptoms and live with his condition. Unwilling to accept a diminished quality of life at a young age, he sought alternative treatments and came across phage therapy. He decided to undertake phage treatment at the Eliava Phage Therapy Center, Tbilisi, Georgia.
Meticulous testing led to result-based phage treatment, as opposed to empirical therapy that is most often prescribed in the case of antibiotic treatments. It took three courses of phage therapy to clear the infection, each course lasting for three months. Standard phage preparations as well as a customised phage preparation made by the Eliava Institute were used for this treatment.
Bacteriological analyses and imaging tests showed significant improvement in the subject’s condition during and after his treatment with phages. This was clinically correlated with symptomatic improvements reported by the subject.
Behind the Paper
The authors have collective and collaborative experience of facilitating phage treatment of patients at the Eliava Phage Therapy Center. Prostatitis patients visit the Center for their treatment from around the world, and their number has been increasing significantly over the last few years. We decided to utilize this experience to write this case report and make detailed information on phage therapy for prostatitis available in an open-access journal.
At the beginning, our aim was to write the paper as a cohort case study of multiple prostatitis patients who had taken phage therapy. One aspect that we decided on early was to ensure that we present each case in depth, with the patient’s condition history, bacteriology reports, imaging results and all other relevant details included. Without this, we believe the impact of the treatment on each individual patient would not have come through.
However, to collate this level of detailed data for multiple patients was proving to be a herculean task. Consequently, we decided to focus on one patient’s experience with prostatitis before, during, and after phage therapy. We also realised that by focusing on a single case, we were better able to do justice to the case presentation and discussion, making the report as impactful as we hoped for. And so, we authored the paper as a case report of an individual patient whose case encompassed a variety of details that we could report on – a complex, multi-pathogenic multidrug resistant infection, treated with multiple phage preparations.
The Relevance of this Case Report
AMR (Antimicrobial Resistance) is increasing at an alarming rate, posing a challenge to medical practitioners and patients alike. Patients today have more information gathering tools available at their disposal than ever before, especially with open-access research and medical journals. With this case report, we hope that patients suffering from chronic infections as well as their doctors can gain confidence in phage therapy from experiential reporting, even while data from clinical trials is awaited.
We also hope that an increasing body of such case reports for different conditions will give impetus to governments and research institutes to develop phage therapy as a credible and much needed alternative to antibiotics in the post-antibiotic era.
Check out the full published case report:
Johri, A. V., Johri, P., Hoyle, N., Pipia, L., Nadareishvili, L., & Nizharadze, D. (2021). Case Report: Chronic Bacterial Prostatitis Treated With Phage Therapy After Multiple Failed Antibiotic Treatments. Frontiers in Pharmacology, 12, 1424.
Read more about Vitalis Phage Therapy:
December 2020 Capsid & Tail interview with Apurva and Pranav, describing the work Vitalis Phage Therapy has done to bring phage susceptibility testing to India:
May 2019 Capsid & Tail interview with Pranav about his experience receiving phage therapy at the Eliava Phage Therapy Center:
Vitalis Phage Therapy website:
Many thanks to Atif Khan and Stephanie Lynch for finding and summarizing this week’s phage news, jobs and community posts!