ABSTRACT
Bacteriophages (phages) may constitute a natural, safe, and effective strategy to prevent and control multidrug-resistant organisms (MDROs), and ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) pathogens in particular. Few clinical studies have assessed the safety and efficacy of phages in patients infected with MDROs. This systematic review summarizes and critically evaluates published studies of phages in clinical practice and presents the appropriate phage selection criteria, as well as recommendations for clinicians and scientists for a successful therapy. Articles were identified through a search of the PubMed, Ovid, EMBASE, and Cochrane Library databases. Among 1102 articles and abstracts, 30 studies were selected and evaluated using selective inclusion criteria, phage criteria, and study characteristics. Most studies showed efficacy (87%) and safety (67%) of the tested phages, but few studies examined phage resistance (35%). Clinical studies and regulatory changes are needed to determine the safety and efficacy of phages and to advance their use in patients with MDRO infections.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Bacterial Infections/therapy , Drug Resistance, Multiple, Bacterial , Phage Therapy , Acinetobacter Infections/prevention & control , Acinetobacter Infections/therapy , Anti-Bacterial Agents/pharmacology , Bacteria/drug effects , Clinical Trials as Topic , Gram-Positive Bacterial Infections/prevention & control , Gram-Positive Bacterial Infections/therapy , Humans , Klebsiella Infections/prevention & control , Klebsiella Infections/therapy , Pseudomonas Infections/prevention & control , Pseudomonas Infections/therapy , Staphylococcal Infections/prevention & control , Staphylococcal Infections/therapyABSTRACT
The auriculotemporal nerve is one branch of the mandibular portion of the trigeminal nerve, which itself divides into several branches in the temporal and retromandibular regions. The lesser occipital nerve is a cutaneous branch of the cervical plexus and is sometimes implicated in cases of cervicogenic headaches, occipitoparietal headaches, and occipital neuralgia, in general. Here, we present a case of unilateral neural interconnection between the auriculotemporal and lesser occipital nerves thus illustrating the joining of the cervical plexus and trigeminal nerve. A better understanding of the aforementioned nervous anatomy may be valuable for facial reconstructive and nerve transfer procedures, as well as for a variety of other head and neck disorders, e.g., occipital neuralgia.