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Polish therapeutic phage research, production and treatment have taken place primarily at the Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw Contact: Director Andre Gorski and Beata Weber-Dubrowska,  
Bacteriophage Therapy of Bacterial Infections: an Update of Our Institute's Experience 2000
Polish therapeutic phage research, production and treatment have taken place primarily at the Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Contact: Director Andre Gorski and Beata Weber, gorski@iitd.pan.wroc.pl http://immuno.pan.wroc.pl/ ARCHIVUM IMMUNOLOGIAE ET THERAPIAE EXPERIMENTALIS RESULTS OF BACTERIOPHAGE TREATMENT OF SUPPURATIVE BACTERIAL INFECTIONS IN THE YEARS 1981 - 1986* Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Czerska 12, 53-114 Wroclaw In the years 1981 - 1986 bacteriophage therapy was applied in 550 cases (100 treated in 1986) of suppurative bacterial infections. Positive results were obtained in 508 cases (92.4%). In 38 cases (6.9%) a transient improvement was observed and in 4 cases (0.7%) phage treatment proved ineffective. Considering that majority of patients (518 cases, 94.2%) were resistant to antibiotic treatment, the results of phage therapy may be regarded as favorable Previous reports1-6 presented the results of phage treatment carried out in 1981 - 1984 (370 cases). Since the results obtained in the group of further 180 cases of 1985 and 1986 did not diverge from those previously published, it was decided to sum up the whole material in the present report. MATERIALS AND METHODS Bacteriophage treatment was applied in 550 patients with septic bacterial infections caused by pyogenic Staphylococci (Staphylococcus) and Gram-negative bacteria (Klebsiella, Escherichia, Proteus, Pseudomonas). They were either spontaneous or postoperative complications. Phage therapy was carried out at clinical or hospital departments, mostly surgery departments. The clinical results of phage therapy were evaluated by a therapeutist. The age of patients ranged from 1 week to 86 years. Of 550 cases examined, the group of children up to 8 years constituted 76 cases (13.8%), group of children and teenagers in the age 9 - 21, 72 cases (13.1%), patients aged 21 - 60 years, predominating, 343 cases-(62.4%) and the smallest groups of patients, above 60 years, numbered 59 cases (10.7%). The number of males-288 cases (52.4%) was slightly higher than that of females-262 cases (47.6%). The number of monoinfections (372 cases - 67.6%) was markedly predominating over polyinfections (178 cases-32.4%). Most numerous were Staphylococcal monoinfections (272 cases -73.1%), less frequent were monoinfections caused by Gram-negative bacilli (100 cases-26.9%). In 151 polyinfection cases, pyogenic Staphylococci (121 cases-68.0%) were predominating over Gram-negative bacilli (57 cases - 32.0%). Phage therapy without parallel antibiotic therapy was applied in 398 cases (72.4%) and parallel administration of bacteriophages and antibiotics in 152 cases (27.6%). The number of cases resistant to antibiotics available amounted to 518 (94.2%). In phage therapy the use was made of virulent bacteriophages, i.e. inducing a complete lysis of bacterial strains isolated from patients. Bacteriophages were administered orally 3 times daily in the dose of 10 ml before the meal, after previous neutralization of gastric juice. Phages were also used locally as moist applications to pleural, peritoneal, cavities, urinary bladder and as eye, ear and nose drops. In the course of treatment, sensitivity of isolated bacteria to phages applied was under control; in the case of confirmed resistance, bacteriophages were changed. The final evaluation of the treatment results was based upon four-degree scale: + + + + outstanding effect manifesting by a complete
recovery, RESULTS While evaluating the final results, it should be taken into consideration that in 518 cases, i.e. in 94.2% the treatment preceding phage therapy failed, among others, due to resistance of bacteria to antibiotics and chemotherapeutics used. Thus, the application of bacteriophages was the only way to eliminate the pyogenic process. Only in 31 cases (5.6%) bacteriophages were used in patients not pretreated with either antibiotics or chemotherapeutics. 1. GENERAL CHARACTERISTICS OF PHAGE THERAPY Detailed information is given in Table 1. Differences between the age groups up to 60 years and the group of patients above 60 years, achieved marked statistical significance. It is very likely that the above may be accounted for a reduced immunity of patients above 60 years of age.
2. Sex of patients and results of phage therapy Phage therapy results in relation to the sex of patients are illustrated in Table 2. The differences observed were statistically significant.
3. Type of infection (monoinfections, polyinfections) and results of phage therapy Detailed data are given in Table 3. The results obtained in both types of infections reveal statistical significance.
4. Results of phage therapy in infections caused by pyogenic Staphylococci and Gram-negative bacteriaThe data presented in Table 4 show that in infections caused by Staphylococci no statistical differences were observed between monoinfections and polyinfections. However, statistically significantly better results were obtained in Gram-negative bacteria-induced [mono- compared to poly-] infections.
5. Method of treatment and result of phage therapy Detailed data are given in Table 5. Statistically significant differences in favor of phage therapy in comparison to the parallelly run phage and antibiotic therapy, were confirmed.
6. State of patients and result of phage therapy The results presented in Table 6 suggest close relation between severity of disease and result of treatment. This problem with particular regard to the immunity state, advancement of the disease and results of phage therapy, requires further elucidation.
II. DETAILED CHARACTERISTICS OF PHAGE THERAPY APPLIED IN PARTICULAR DISEASE CATEGORIES Classification into categories and nosologic units has been based on
the recommendations of the World Health Organization included in the publication:
Manual of the International Statistical Classification of Diseases, Injuries
and Cause of Death, Vol. 1 WHO, Geneva, 1977. Detailed data are listed
in Table 7. Table 7. List of disorders as divided into disease categories with regard to nosologic units, monoinfections and polyinfections Categories and Nosologic units I. Infections diseases1. Infections diseases of the alimentary tract 2. Septicaemias VI. Diseases of the nervous system and sense organs VII. Diseases of the circulatory system VIII. Diseases of the respiratory system IX. Diseases of the digestive system X. Diseases of the genitourinary tract XII. Diseases of the skin and subcutaneous tissue XIII. Diseases of the musculoskeletal system XVII. Injuries Category I - 1 Infectious diseases of the alimentary tract Three cases of bacillary dysentery, 2 cases of colibacteriosis, 1 case of Salmonellosis and 1 case of acute diarrhoea due to mixed infection with Staphylococci, Klebsiella bacilli and Escherichia, were submitted to phage therapy. In all the 7 cases oral administration of bacteriophages for 1 to 3 weeks, resulted in a subsidence of the clinical symptoms and elimination of the infection process.
Septicaemia was confirmed in 98 of 550, i.e. in 17.8% cases submitted to phage therapy. The cases belonged to various disease categories. Monoinfections were recognized in 48 cases and polyinfections in 50. In monoinfections septicaemia was caused in the majority of cases by pyogenic Staphylococci (32 cases), and less frequently by Gram-negative bacteria (Klebsiella-5, Escherichia- 5, Pseudomonas-6). In polyinfections most frequent appeared Klebsiella (37 cases), pyogenic Staphylococci (30 cases), Escherichia (30 cases), Pseudomonas (26 cases) and less frequent were Proteus bacteria (10 cases). Positive therapeutic result was obtained in 87 cases (88.8%) and transient improvement in 7 cases. In 4 cases which ended with exitus, bacteriophages appeared ineffective (too late application at great cachexy of patients). Category VI - 3 Blepharitis, conjunctivitis and otitis media This group numbered 16 patients: 7 with purulent conjunctivitis, 3 with
recurrent hordeolum. 1 with dacryocystitis and 5 with otitis media. All
the cases proved resistant to antibiotics. Pyogenic Staphylococci were
isolated in monoinfections (13 cases), pyogenic Staphylococci and Klebsiella
bacteria in 3 cases of polyinfections and Pseudomonas and Proteus bacteria
in 1 case each. Application of bacteriophages as eye and ear drops and
moist applications fully eliminated the infection. This group comprised 10 cases. In 9 patients meningitis resulted from operative infections and in 1 from septicaemia. All the cases were resistant to antibiotic treatment. Of 3 monoinfection cases, in 1 pyogenic Staphylococci was confirmed and in 2 Klebsiella bacilli. Klebsiella bacilli were predominating in polyinfections (6 cases of 7 cases), also frequent were pyogenic Staphylococci (5 cases); Escherichia and Proteus were encountered only in 2 cases each. In 9 cases phage therapy gave way to an elimination of pyogenic process. In 1 case due to the mixed infection with Klebsiella, Escherichia and Pseudomonas, exitus was reported. Category VII - 5 Varicose veins of legs This group included 36 patients. Of 23 monoinfection cases, 15 were caused by pyogenic Staphylococci, 7 by Pseudomonas and 1 case by Klebsiella bacteria. Of 13 polyinfections cases, Pseudomonas were confirmed in 7 cases, pyogenic Staphylococci in 4 cases and Escherichia in 1 case. All the cases were resistant to antibiotics. In 27 cases phage therapy resulted in a total elimination of the infection and in 9 marked improvement with tendency towards healing was confirmed. Category VII - 6 Acute purulent pericarditis This groups comprised 7 cases of pyopericardium (complications after operations on open heart and large vessels). In monoinfections (5 cases) pyogenic Staphylococci was recognized as a causative factor and polyinfections (2 cases) were caused by Pseudomonas, Escherichia and pyogenic Staphylococci. In all the cases antibiotic treatment brought no effect. In 6 cases phage therapy eliminated the infection and in 1 marked improvement was observed with a tendency towards healing of the wounds. Category VIII - 7 Suppurative inflammation of the respiratory tract Of 74 cases classified to this group, 51 patients suffered from suppurative inflammation of the nasal cavity, rhinitis, recurrent angina and 23 patients from mucopurulent bronchitis. Monoinfections were confirmed in 53 cases of which the majority was caused by pyogenic Staphylococci (46 cases) and a few cases by Escherichia (4 cases) Klebsiella bacilli (2 cases) and Proteus (1 case). In 21 cases of polyinfections, most frequent were pyogenic Staphylococci (15 cases), Klebsiella bacilli (14 cases), less frequent were Escherichia (7 cases), Pseudomonas (6 cases), Proteus (2 cases) and Streptococcus viridans (1 case). Of 74 cases, in 69 antibiotic treatment failed. In 4 cases phage therapy was not preceded by antibiotic application. Phages appeared ineffective in 1 case, transient improvement was obtained in 6 cases and in the remaining 67 (91.9%) the suppurative process was fully eliminated. Category VIII - 8 Bronchopneumonia, pneumonia abscedens This group numbered 57 cases; 20 monoinfections and 37 polyinfections.
Monoinfections were mostly caused by pyogenic Staphylococci (9 cases),
Pseudomonas (8 cases) and Klebsiella bacilli (3 cases). In polyinfections
predominating were: Pseudomonas (25cases) Klebsiella and Escherichia (23
cases each) and pyogenic Staphylococci (22 cases), less frequent were
cases with Proteus (7 cases). In 54 cases antibiotics administration proved
to have no effect upon the course of infection. In 3 cases antibiotics
were not applied. Phage therapy eliminated the suppurative process in
47 cases (82.5%) and in the remaining 10 cases it had unfavorable influence
upon the infection. In 6 cases polyinfections resulted in exit. Category VIII - 9 Pneumonia with thoracic empyema and fistulas This group included 27 cases: 11 monoinfections and 16 polyinfections. The former ones were caused by pyogenic Staphylococci (6 eases), Pseudomonas (3 cases) and Klebsiella bacilli and Escherichia (1 case each). In polyinfections predominating were: Pseudomonas (13 cases), Klebsiella (10 cases), pyogenic Staphylococci (8 cases), Escherichia bacilli (8 cases) and Proteus (5 cases). Antibiotic treatment was ineffective in 23 cases. In 3 cases the treatment terminated only in a transient improvement and 1 in exit. In the remaining 23 cases (85.2%), suppression of the infection in the lungs and thoracic cavity was observed. Category VIII - 10 Thoracic empyemas with fistulas This groups numbered 22 cases of which 13 were monoinfections caused by pyogenic Staphylococci (6 cases), Pseudomonas (4 cases), Klebsiella (2 cases) and Escherichia (1 case), and 9 polyinfections caused by pyogenic Staphylococci (9 cases), Pseudomonas (7 cases), Klebsiella (5 cases) and Escherichia (4 cases). Antibiotic therapy was ineffective in 20 cases. In 2 cases antibiotics were not applied. Phage therapy eliminated the suppurative process in 19 cases (86.4%) and gave way to marked improvement in 2 cases. One case resulted in exitus. Category IX - 11 Acute gingivitis, purulent peritonitis and abdominal abscesses To this category 65 cases were included: 2 cases of acute purulent gingivitis
and stomatitis and 63 cases of suppurative peritonitis due to suppurative
or gangrenous acute appendicitis, gastric resection, cholecystectomy,
suppurative pancreatitis and operations on intestines. Antibiotics proved
ineffective in 63 cases. Thirty eight cases of monoinfections were mostly
caused by Escherichia (20 cases), pyogenic Staphylococci (12 cases), Pseudomonas
(3 cases) and Klebsiella (3 cases). Polyinfections were confirmed in 27
cases and were caused by Klebsiella (18 cases), Pseudomonas (17 cases)
and Escherichia (17 cases), pyogenic Staphylococci (13 cases), and Proteus
(4 cases). Bacteriophage were applied orally and locally (for the washing
of operation field and to the fistulas); Good therapeutic result was reported
in 59 cases (90.8%). In 5 cases marked improvement with the tendency toward
fueling of the wounds was noted and in 1 phage therapy was ineffective.
Local application of bacteriophages in ulcerative gingivitis brought about
full elimination of the suppurative process within 2 weeks. Category X - 12 Suppurative inflammations of the genitourinary tract This category comprised 42 cases: 40 cases of suppurative inflammation of the genitourinary tract and 2 cases of postoperative suppurative vaginitis. Monoinfections caused by Pseudomonas (8 cases), Escherichia (5 cases), pyogenic Staphylococci (3 cases), Klebsiella (1 case) and Proteus (1 case), were confirmed in 18 cases. Polyinfections numbered 24 cases and were caused by Pseudomonas (16 cases), Escherichia (16 cases) and pyogenic Staphylococci (14 cases), Klebsiella (12 cases) and Proteus bacteria (4 cases). In 37 cases antibiotic therapy was without effect. Application of phage therapy in 39 cases (92.9%) resulted in elimination of the infection and sterilization of urine. One patient revealed marked improvement and 2 - lack of improvement. In 2 cases of suppurative vaginitis due to infection with pyogenic Staphylococci, the washings with the specific bacteriophages totally eliminated the inflammation. Category XII - 13 Furunculosis This groups included 55 cases of furunculosis of various localization. In 50 cases monoinfections caused by pyogenic Staphylococci were confirmed. In 5 cases of polyinfection, the presence of pyogenic Staphylococci (5 cases), Escherichia (3 cases) pyogenic Staphylococci and Pseudomonas (1 case each) was confirmed. All the cases were resistant to antibiotic treatment. Good therapeutic result was obtained in all the cases (100%) after oral and local application of bacteriophages. Category XII - 14 Diseases of the connective tissue and lymphatic vessels This group included 91 cases of skin inflammations: abscesses, phlegmone of various localization, acne necrotica and 11 cases of abscesses mammae. Seventy-four cases appeared to be monoinfections caused by pyogenic Staphylococci (65 cases), Pseudomonas (5 cases), Klebsiella (3 cases), Escherichia (1 case). In 17 cases of polyinfections there were isolated pyogenic Staphylococci (15 cases), Klebsiella (10 cases), Escherichia (7 cases), Pseudomonas (9cases) and Proteus (4 cases). In 83 cases antibiotic treatment appeared ineffective. Phage therapy eliminated the infection in 86 cases (94.5%). Five cases revealed marked improvement with tendency towards healing. Category XII - 15 Decubitus ulcer Of 16 cases of long-term decubitus ulcer, monoinfections were confirmed in 2. Pyogenic Staphylococci were recognized to be the causative factor. In 14 cases of polyinfection, different bacterial flora was encountered: pyogenic Staphylococci (11 cases), Pseudomonas (10 cases), Escherichia and Klebsiella (9cases each) and Proteus (6 cases). All the cases were resistant to antibiotics. Application of phage therapy, oral and local, resulted in favorable effect in 13 cases. In 3 cases phage treatment was ineffective. Category XIII - 16 Purulent arthritis and myositis This group numbered 19 cases: 15 cases of purulent arthritis and 4 cases of myositis. Thirteen of them were monoinfections caused by pyogenic Staphylococci (12 cases), Proteus (1case). Polyinfections numbering 6 cases were caused by pyogenic Staphylococci (5 cases), Pseudomonas (3 cases), Proteus (4 cases), Klebsiella (2 cases) and Escherichia (2 cases). All the cases were resistant to antibiotic treatment. Application of phage therapy eliminated the suppurative process in 17 cases (89.5%). In 2 cases no improvement was reported. Category XIII - 17 Osteomyelitis of the long bones This group included 40 cases of osteomyelitis of long bones. Monoinfections confirmed in 29 cases were due to infection with pyogenic Staphylococci (25 cases) in 3 cases Pseudomonas bacilli were isolated and in 1 Klebsiella bacilli. In 11 cases mixed infections was confirmed caused by pyogenic Staphylococci (7 cases), Pseudomonas (5 cases), Proteus, Klebsiella and Escherichia (4 cases each). Thirty-eight of 40 cases appeared resistant to antibiotics. Suppurative
process was eliminated due to application of phages in 38 cases (95.0%).
Two cases revealed a transient improvement. Category XVII - 18 Open wounds, laparotomy, tracheostomy, contusions and burns This group included 49 cases (22 monoinfections and 27 polyinfections). The former ones were caused by pyogenic Staphylococci (11cases), Pseudomonas (5 cases), Escherichia (4 cases) and Klebsiella (2 cases). In polyinfections the presence of various bacterial flora was confirmed consisting madly of Klebsiella (16 cases), Pseudomonas (14 cases), Escherichia (16 cases), Proteus (9 cases) and pyogenic Staphylococci (15 cases). Antibiotic therapy was ineffective in 46 cases. Oral and local application of bacteriophages eliminated the infection in 42 cases and in 7 brought about a transient improvement. Category XVII - 19 Contusions of head with suppuration of wounds This group comprised 23 cases, including 13 cases of monoinfection and 10 of polyinfection. In monoinfections the suppuration was due mostly to pyogenic Staphylococci (10 cases), rarely Klebsiella, Escherichia and Pseudomonas (1 case each). In polyinfections frequently met were: Pseudomonas (9 cases), Klebsiella (7 cases), pyogenic Staphylococci (6 cases) and Escherichia (5 cases). The remaining 22 cases, with 1 exception, were resistant to antibiotics. Application of bacteriophages orally and locally, eliminated the infection in 19 cases (82.6%), in 2 resulted in marked improvement and in 4 in transient improvement. Category XVII - 20 Injuries of spine (suppuration of wounds) This group numbered 12 cases: 8 monoinfections and 4 polyinfections. In the former group pyogenic Staphylococci were predominating and in the latter they were encountered in 4 cases, Klebsiella and Escherichia bacilli in 2 cases each, and Proteus in 1 case. All of the cases were resistant to antibiotic treatment. Application of phage therapy allowed elimination of the suppurative process. Marked improvement with the healing of the wound and transient improvement were reported in 1 case each. Category XVII - 21 Ostitis of the long bones after fracture This group included 41 cases: 24 monoinfections and 17 polyinfections. Monoinfections were caused mainly by pyogenic Staphylococci (21 cases), Escherichia and Proteus (1 case each). In polyinfections predominating were pyogenic Staphylococci (14 cases), Pseudomonas (10 cases), Klebsiella (6 cases). Escherichia (7 cases) and Proteus (3 cases). Resistance to antibiotics was confirmed in 37 cases. Bacteriophages applied orally and locally eliminated the infection in 37 cases (90.2%). In 4 cases only a transient improvement was reported. Category XVII - 22 Chronic suppurative fistulas This group comprised 180 cases in which the infections resulted in long-persisting suppurative fistulas. Monoinfections (118 cases) caused by pyogenic Staphylococci numbered 92 cases. Escherichia bacilli were recognized in 13 cases, Pseudomonas in 6 cases and Klebsiella in 7 cases. In polyinfections (62 cases) predominating were: pyogenic Staphylococci (38 cases), Klebsiella (33 cases), Pseudomonas (30 cases), Escherichia (31 cases) and Proteus (15cases). In all the cases observed antibiotics were not effective. Bacteriophages applied orally and locally (to the fistulas) eliminated the infection in 168 cases (93.3%) and healed the fistulas. Marked improvement with the tendency toward healing of the wounds was reported in 12 cases. RECAPITULATION OF THE RESULTS AND CONCLUSIONS Detailed analysis of 550 cases of suppurative bacterial infections subjected to phage therapy allowed the following conclusions: 1. Specific phage therapy is highly effective in the infections caused by pyogenic Staphylococci and Gram-negative bacteria (Klebsiella, Escherichia, Proteus, Pseudomonas). Positive therapeutic result was observed in 508 cases of 550 examined, i.e. in 92.4%. This percentage ranged from 75.9% to 100%, in accordance with etiologic factor and type of infection. 2. Differences in positive results of phage therapy in the age group up to 60 years achieved statistical significance as compared to the age group above 60 years. 3. Statistically significant differences related to the sex of patients were also confirmed. 4. Difference in effectivity of phage therapy in monoinfections and polyinfections were statistically significant. They were most drastic in the group of infections caused by Gram-negative bacilli. In the Staphylococcal infections they were negligible. 5. Phage therapy is particularly useful in the cases where antibiotic therapy failed. In the material studied the number of cases resistant to antibiotics was as high as 518, i.e. 94.2%. 6. Phage therapy is recommended in the following pathological states: 7. Effectivity of phage therapy as compared to the combined treatment of phages and antibiotics revealed statistical significance. 8. Statistically significant differences related to the severity of the disease were also observed. 9. Bacteriophage treatment may last long, up to full elimination of the infective process. Side effects are rarely encountered. 10. The routs of bacteriophage administration depend upon a localization of suppuration focus. Oral administration of phages is recommended in each case. Bacteriophages easily penetrate from the alimentary tract to the blood circulation system and are excreted with the urine. With great effectiveness they were also applied as moist applications to the wounds, eye, ear and nose drops, infusions to the fistulas, washings of the nasal cavity, urinary bladder, suppurative lesions of pleura and peritoneum, decubitus, fistulas, intravaginally intraoperatively for the washing of peritoneal cavity and in the cases of multiple skin abscesses. 11. Bacteriophages are of great value in prophylaxis (in preparing the patients for orthopaedic surgeries, in skin transplantations). 12. Unfavorable treatment results may be accounted, to a great extend, to too late initiation of the treatment and also great cachexy of patients with long course of disease. 1. SLOPEK S., DURLAKOWA I., WEBER-DABROWSKA B., KUCHAREWICZ-KRUKOWSKA A., DABROWSKI M. and BISIKIEWICZ R.: Results of bacteriophage treatment of suppurative bacterial infections. 1. General evaluation of the results. Arch. Immunol. Ther. Exp., 1983, 31, 267 - 291. 2. SLOPEK S., DURLAKOWA I., WEBER-DABROWSKA B., KUCHAREWICZ-KRUKOWSKA A., DABROWSKI M. and BISIKEWICZ R.: Results of bacteriophage treatment of suppurative bacterial infections. 11 Detailed evaluation of the results. Arch. Immunol. Ther. EXP., 1983, 31, 293 - 327. 3. SLOPEK S., DURLAKOWA 1., WEBER-DABROWSKA B., DABROWSKI M. and KUCHAREWICZ-KRUKOWSKA A.: Results of bacteriophage treatment of suppurative bacterial infections. 111. Detailed evaluation of the results obtained in further 150 cases. Arch. Immunol. Ther. EXP., 1984, 32, 317-335. 4. SLOPEK S., KUCHAREWICZ-KRUKOWSKA A., WEBER-DABROWSKA B. and DABROWSKI M.: Results of bacteriophage treatment of suppurative bacterial infections. IV. Evaluation of the results obtained in 370 cases. Arch. Immunol. Ther. Exp., 1985, 33, 219 - 240. 5. SLOPBK S., KUCHAREWICZ-KRUKOWSKA A., WEBER-DABROWSKA B. and DABROWSKI M.: Results of bacteriophage treatment of suppurative bacterial infections. V. Evaluation of the results obtained in children. Arch. Immunol. Ther. Exp., 1985, 33, 241 - 260. 6. SLOPEK S., KUCHAREWTCZ-KRUKOWSKA A., WEBER-DABROWSKA B. and DABROWSKI
M.: Results of bacteriophage treatment of suppurative bacterial infections.
P7. Analysis of treatment of suppurative Staphylococcal infection. Arch.
Immunol. Ther. Exp., 1985, 33, 261 - 275. Received in March 1987. |
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