Examining the Efficacy and Safety of Bacteriophage Therapy on ESKAPE Pathogens and Its Potential Implications for Mitigating Disease Outbreaks
John Ehi AbojeAntimicrobial resistance (AMR) poses a global health crisis, with ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp.) driving severe, multidrug-resistant infections. Bacteriophage therapy (PT) offers a targeted alternative; however, its clinical efficacy, safety, and potential outbreak mitigation remain underexplored. This narrative review synthesized evidence from 30 clinical studies to evaluate PT for ESKAPE infections. Complete bacterial clearance was achieved in 10 studies, primarily for P. aeruginosa and K. pneumoniae, with clinical improvement in 24 studies, including complex cases like osteomyelitis and cystic fibrosis-related pneumonia. PT was safe, with no serious adverse effects across 25 studies; mild, transient events (e.g., fever) were rare. Mortality, reported in nine studies, was unrelated to PT. One study demonstrated a reduction in nosocomial transmission of A. baumannii using environmental phages, suggesting a potential for outbreak control. PT shows promise as a safe, effective adjunct for MDR infections, but larger trials and standardized protocols are needed to address resistance, optimize dosing, and explore public health applications.