Abstract
Antimicrobial resistance is increasing despite new treatments being employed. With a decrease in the discovery rate of novel antibiotics, this threatens to take humankind back to a “pre-antibiotic era” of clinical care. Bacteriophages (phages) are one of the most promising alternatives to antibiotics for clinical use. Although more than a century of mostly ad-hoc phage therapy has involved substantial clinical experimentation, a lack of both regulatory guidance standards and effective execution of clinical trials has meant that therapy for infectious bacterial diseases has yet to be widely adopted. However, several recent case studies and clinical trials show promise in addressing these concerns. With the antibiotic resistance crisis and urgent search for alternative clinical treatments for bacterial infections, phage therapy may soon fulfill its long-held promise. This review reports on the applications of phage therapy for various infectious diseases, phage pharmacology, immunological responses to phages, legal concerns, and the potential benefits and disadvantages of this novel treatment.
Highlights
There are approximately 1030-31 bacteriophages in the biosphere [1,2], which is estimated to be 10-fold higher than the total number of bacterial cells [3]
It is important to understand the concepts of multiplicity of infection (MOI), which is the ratio of phage infections per bacteria, and MOI input, which is the number of phages that are administered per cell
This study showed that phage treatment decreased bacterial burden in burn wounds in more time than the standard treatment
Summary
There are approximately 1030-31 bacteriophages (phages) in the biosphere [1,2], which is estimated to be 10-fold higher than the total number of bacterial cells [3]. Phages are one of the most promising alternatives to antibiotics, which can be used for medicine, agriculture, and related fields [7]. There historically has been no fit for purpose regulatory framework to deal with novel flexible and sustainable therapeutic approaches such as phages. This includes oversight of the setup and approval of adequate clinical trials, so as a result, there is no standard protocol for phage therapy. We summarize the phage therapy clinical trials that have shown promising results in patients. Antibiotics 2019, 8, 138 concerns about phage therapy, phage genetic modification, and a description of the advantages and disadvantages of phage therapy when compared to conventional treatments with antibiotics
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