Entrega local baseada em hidrogel de bacteriófagos para controle de infecção: uma revisão sistemática de evidências in vivo

Resumo original em inglês

O que aconteceu

Localized biofilm-associated infections remain difficult to treat with systemic antibiotics amid rising resistance. Hydrogel delivery may enhance bacteriophage (phage) therapy by protecting phages, prolonging residence, and enabling controlled release. This systematic review summarizes in vivo evidence for hydrogel-mediated phage delivery and its translational relevance.

Following PRISMA 2020, PubMed, Web of Science were searched to 14 January 2026 using MeSH terms for bacteriophages, hydrogels/local delivery, and in vivo or clinical applications. Eligible studies reported original in vivo animal or human data; in vitro-only work was excluded.

O que encontraram

Nineteen studies met criteria: three clinical and sixteen preclinical. Clinical use included fracture-related infection, burn wound, and prosthetic joint infections treated with commercially available phage preparations in hydrogels. In a single compassionate-use fracture-related infection case managed with concurrent surgical debridement and systemic antibiotics, infection control without recurrence and good bone was were observed at one year; locally applied phages remained detectable for approximately 72 h, indicating in vivo release and surgical compatibility, although the independent contribution of the hydrogel-phage component could not be isolated. Preclinical studies tested 28 phages against six bacterial species via topical, injected, intraoperative, oral, or irrigation delivery. Consistent benefits occurred in burn wound infection (n = 6) and wound/soft-tissue infection models (n = 5) with lower bacterial load, improved healing, and increased survival in two burn wound infection studies. Bone/joint models (n = 4) showed partial reduction but inconsistent eradication. Other studies demonstrated ∼2000-fold pathogen reduction in colitis and decreased bacterial and inflammatory markers in endodontic infection.

Por que isso importa

Hydrogel-based local phage therapy is a feasible strategy for infection control No major adverse effects were reported in the included studies, although safety reporting was limited. Standardized in vivo comparisons and clinical trials are needed to optimize delivery and dosing.

Resumo publicado sob licença CC BY. A tradução para o português ainda não chegou a este estudo.