Phages in Treatment of Some Deep Purulent Skin Infections

Introduction. The questions of treatment of chronic skin purulent infections are extremely important due to their wide spread, severe clinical course of some nosological forms, development of resistance to the traditional means, and growth of undesirable side effects of antibiotic therapy. The aim of this communication, which is a continuation of previously presented research, is to report the data and results of treatment of some common chronic suppurative skin disease with phages. Materials and methods. In the present investigation were included 87 males aged 18 to 56 with chronic folliculites (n=52), syccosis (n=30) and folliculitis et perifolliculitis capitis abscendens et suffodiens, Hoffmann (n=5), in all cases was approved prevalence of staphylococcal flora and all of them were treated before with antibiotics, but unsuccessfully. The treatment was provided with pyophages produced by Giorgi Eliava Institute (Tbilisi, Georgia) which include Staphylococcus aureus, Streptococcus (different cultures), Escherichia coli (different serotypes), Psedomonas aeruginosa, Proteus vulgaris, mirabilis. Taking into consideration deep locations for treatment was chosen mesotherapy technique – phage solution was injected by dermal nappage, papula and point by point technique in all damaged areas. In each case the frequency of procedures was usually once in 3-4 days until healing, the process took about one month. In patients with folliculitis full recovery was achieved in all cases, but they were still under observation up to 2 months in order to avoid relapses. In the cases of folliculitis et perifolliculitis capitis abscendens et suffodiens Hoffmann treatment was started with М. Jessner's peeling followed by intralesional injections into buggy nodules and sinus tracts and dermal nappage, papula and point by point technique in all damaged areas. Patients were treated within three weeks once in three days with following break of 7 days, after the course was repeated. In all 5 cases the final results were positive. The cosmetic defect in the form of a fibroid growth was still present, but after the course of treatment the laboratory data confirmed the absence of pathogenic flora in correlation with marked clinical improvement. Conclusions. There is a need to develop phage therapy of purulent skin diseases, but more research is needed to understand the bacteria-bacteriophage interactions in the skin community to obtain comprehensive knowledge on different pathogenic flora.