METHOD OF TREATMENT OF INFECTION RELATED TO THE PROVISION OF MEDICAL ASSISTANCE CAUSED BY A CAUSATIVE AGENT OR PATHOGENS WITH MULTIPLE DRUG RESISTANCE Russian patent published in 2018 - IPC A61K35/76 A61P31/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely, immunology and infectious diseases, and can be used to treat an infection caused by a causative agent or pathogens with multiple drug resistance by carrying out personified phage therapy. For this purpose, select a bacteriophage or bacteriophages in two stages, determining the sensitivity of the target bacteria isolated from the patient to individual strains of virulent phages. In the first stage, use a spot test on a dish with a bacterial lawn sown on a dense nutrient medium containing 1.5–2 % agar, selecting phage or phages, under the influence of which there was a complete or partial lysis of the bacterial lawn or in the area of the applied spot there are separate negative colonies. In the second stage, apply the selected phage or phage drops of 10–100 mcl over the frozen second layer of the agar medium to a cup or petri dish, with the first layer being applied with 1.5–2 % nutrient agar, on which after its solidification by a second layer, a 0.7 % agar medium containing a bacterial culture isolated from the patient is applied. For application, use bacteriophages in a titer providing a multiplicity of infection from 0.01 to 1, taking into account the titer of the target bacterium sown from the infection site; select a phage or phages, under the influence of which the formation of individual negative colonies or the drainage lysis of the bacterial culture occurred, the results in the first and second stages are taken into account after incubating the plates at 37 °C for 18 hours. Then, by means of an enzyme immunoassay, determine the presence of IgG antibodies to the selected phage or phages in the patient's serum, after which perform the neutralization reactions, confirming the neutralizing properties of the antibodies found, and phages or phages are selected to which the patient lacks IgG antibodies that have confirmed neutralizing properties. Further, considering the localization of the infectious process and the pharmacokinetics of the selected phage or phages, determine at least one of the following routes of administration: per os, per rectum, inhalation, topically and corresponding to this route of administration, a dosage form, ensuring the preservation of bacteriophages in the focus of infection in the titer is no more than two orders of magnitude lower than the original, contained in the drug used in the patient, during the entire period of isolation from the focus of infection of the target bacterium and at least 24–48 hours after its elimination.

EFFECT: use of this method allows for effective phagotherapy of infections caused by pathogens with multiple drug resistance, by a personified selection of the bacteriophage strain, the establishment of individual doses of the drug administered, and also taking into account the antiphagic immune response of the patient.

3 cl, 4 ex