2.5. Original Protocol of Phage-Antibiotic Combination Therapy
In the SG, 6.0 mL of a staphylococcal bacteriophage solution was added during mixing bone cement, without vacuum, before placement of the endoprosthesis components. Such an application of phages has been previously developed by in vitro deposition of phage particles in surface cavities of polymethyl methacrylate implants prepared In the SG patients, from 5 mL to 10 mL of wound fluid was sampled from a drainage tube on day 4 ± 1 of the postoperative period to monitor the efficacy of phage therapy under hospital conditions. All subsequent wound fluid samples, after day 4 ± 1, were taken on demand. Samples were microbiologically examined and interpreted according to our patented method [Because phage therapy was used in the SG in combination with antibiotics (not as monotherapy ), all patients of this group were additionally prescribed etiotropic antibiotic therapy after surgical treatment, for up to twelve weeks, according to the regimens described below. Under hospital conditions (first two weeks), depending on the pathogen, vancomycin was administered as an intravenous drip infusion, at a dose of 1.0 g twice a day, or cefazolin as an intravenous drip infusion at a dose of 2.0 g three times a day, [Ciprofloxacin at a dose of 0.5 g, twice a day for twenty-one days; and rifampicin at a dose of 450 mg, twice a day for ten weeks;Trimethoprim/sulfamethoxazole at a dose of 480 mg, twice a day for one month; then doxycycline at a dose of 100 mg, twice a day for eight weeks.