Is phage therapy suitable for treating chronic sinusitis Staphylococcus aureus infection?

The extensive use of antibiotics, proper and improper, has provided selective pressure on bacteria to evolve toward resistance. The common opportunistic bacterial pathogen Staphylococcus aureus is notorious for resisting a broad variety of antibiotics, especially in biofilm form. One clinical setting in which this bacterium, and its antibiotic resistance, is problematic is in chronic sinus infections, which are associated with chronic rhinosinusitis (CRS). In the USA, where the population prevalence of CRS is thought to be as high as 16%, its direct annual cost to healthcare systems is estimated at over USD$10 billion, and its indirect cost due to work-related productivity losses is in excess of USD$20 billion. The presence of S. aureus biofilms in CRS is associated with a number of adverse outcomes and increased disease severity, such as more frequent out-patient visits, increased risk of recurrent infections and antibiotic use as well as poorer progression following sinus surgery.