Antibiotics and bacteriophage therapy in surgical site infection prevention and treatment: a structured evidence-mapping review with descriptive safety and outcome summaries

Aim. Surgical site infection (SSI) remains a major postoperative complication and contributes to prolonged wound care, antibiotic exposure, antimicrobial resistance and healthcare costs. Bacteriophage therapy has re-emerged as a targeted antibacterial approach, but the available clinical literature includes very different contexts, ranging from routine antibiotic prophylaxis to salvage treatment of chronic, biofilm-associated or implant-related infections. Materials and methods. This article is presented as a structured evidence-mapping review with descriptive safety and outcome summaries, not as a full systematic review or meta-analysis. A complete database screening log, duplicate-removal record, full-text exclusion list and prospectively documented PRISMA flow counts were not available. Therefore, the findings should be interpreted as an evidence map based on an extracted source set rather than as an exhaustive systematic synthesis of all available literature. Clinical sources were classified by clinical purpose: SSI prevention, treatment of established infection, chronic wound/diabetic foot infection and prosthetic joint/implant-associated infection. Outcomes were separated into negative prevention outcomes, such as SSI incidence, and positive treatment outcomes, such as wound healing, bacterial eradication or clinical resolution. Methodological confidence was considered according to study design using principles consistent with RoB 2, ROBINS-I, JBI checklists, AMSTAR 2 and GRADE. Results. Antibiotic-only prophylaxis studies reported variable SSI or wound-infection rates, with a descriptive event summary of 11.17% in general-surgery prophylaxis. Phage evidence was concentrated mainly in treatment settings, where endpoints included infection resolution, eradication, reduced bacterial burden or wound healing. Phage-only chronic-wound studies showed an 80.9% descriptive success/healing/burden-reduction signal, whereas phage-only orthopedic evidence was based mainly on very small case reports or case series. One small phage-plus-antibiotic prophylaxis study reported 13.63% SSI in the intervention group. These descriptive summaries are not directly comparable across prevention and treatment categories and should not be interpreted as comparative efficacy estimates. Conclusion. Antibiotic prophylaxis remains the most established approach for SSI prevention. Current clinical evidence suggests that bacteriophage therapy may be a promising adjunct for selected complicated, resistant or biofilm-associated infections, but its role in routine SSI prevention remains insufficiently defined. Available safety data indicate a generally favorable short-term tolerability signal, although this conclusion is limited by small samples, heterogeneous reporting and scarce standardized microbiome or resistance surveillance. Larger prospective controlled studies with reproducible search and reporting frameworks are needed before broad perioperative implementation can be recommended.

Ҳали таржима қилинмаган