Abstract
In an era of proliferating multidrug resistant bacterial infections that are exhausting the capacity of existing chemical antibiotics and in which the development of new antibiotics is significantly rarer, Western medicine must seek additional therapeutic options that can be employed to treat these infections. Among the potential antibacterial solutions are bacteriophage therapeutics, which possess very different properties from broad spectrum antibiotics that are currently the standard of care, and which can be used in combination with them and often provide synergies. In this review we summarize the state of the development of bacteriophage therapeutics and discuss potential paths to the implementation of phage therapies in contemporary medicine, focused on fixed phage cocktail therapeutics since these are likely to be the first bacteriophage products licensed for broad use in Western countries.
Highlights
The use of the viruses of bacteria, bacteriophages, as therapeutic agents to treat bacterial infections began 20 years before the first clinical use of an antibiotic drug, but the introduction of broad-spectrum antibiotics in the 1940s rapidly eclipsed and displaced the development of phage therapeutics in much of the world
Multidrug resistance combined with the slowing development of new antibiotics over the past few decades [5,6] threatens to further reduce treatment options for previously curable infections, so Western scientific and medical communities are reengaging to develop phage therapies to help contend with this burgeoning problem
Eli Lilly Company began the production of seven phage therapeutic preparations in the US, but this effort was plagued with technical problems and was abandoned as antibiotic drugs came into production and use
Summary
The use of the viruses of bacteria, bacteriophages (phages), as therapeutic agents to treat bacterial infections began 20 years before the first clinical use of an antibiotic drug, but the introduction of broad-spectrum antibiotics in the 1940s rapidly eclipsed and displaced the development of phage therapeutics in much of the world. Multidrug resistance combined with the slowing development of new antibiotics over the past few decades [5,6] threatens to further reduce treatment options for previously curable infections, so Western scientific and medical communities are reengaging to develop phage therapies to help contend with this burgeoning problem. Phages infect their specific bacterial hosts and in the lytic (or virulent) lifestyle highjack the machinery of the host cell to replicate and destroy the host, simultaneously producing progeny and killing the host. (f) multiplying the components of cocktails to expand their therapeutic spectrum will make large-scale production of phage therapeutics more complex and expensive; (g) the human immune response to phages used for therapy is not completely understood and could potentially impede efficacy or cause unwanted immune responses [11,12,13,14,15]
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