A Phage Therapy Guide for Clinicians and Basic Scientists: Background and Highlighting Applications for Developing Countries

Abstract

Approximately 10% of global health research is devoted to 90% of global disease burden (the so-called “10/90 Gap”) and it often neglects those diseases most prevalent in low-income countries. Antibiotic resistant bacterial infections are known to impact on healthcare, food security, and socio-economic fabric in the developing countries. With a global antibiotic resistance crisis currently reaching a critical level, the unmet needs in the developing countries are even more striking. The failure of traditional antimicrobials has led to renewed interest in century-old bacteriophage (phage) therapy in response to the urgent need to develop alternative therapies to treat infections. Phage therapy may have particular value in developing countries where relevant phages can be sourced and processed locally and efficiently, breaking specifically the economic barrier of access to expensive medicine. Hence this makes phage therapy an attractive and feasible option. In this review, we draw our respective clinical experience as well as phage therapy research and clinical trial, and discuss the ways in which phage therapy might reduce the burden of some of the most important bacterial infections in developing countries.

Practical Assessment of an Interdisciplinary Bacteriophage Delivery Pipeline for Personalized Therapy of Gram-Negative Bacterial Infections

“…(1) Possible routes of administration for phage therapy have been published in case reports, and they include, depending on the site of the infection, intravenous, rectal, inhalative, intranasal, oral, intra-surgical, and topical application [34,[58][59][60]. The route of administration can be adapted during treatment.…”

Role of Bacteriophages for Optimized Health and Production of Poultry

“…In the deployment of phage therapy, the World Health Organization (WHO) must play an important role, according to the authors’ recommendations. A vaccine prequalification program (PQ) by the WHO, for example, could contribute to the promotion of PT knowledge and the development of a regulatory system for phage products [ 80 ].…”

Phage-specific immune responses impair efficacy of phage therapy targeting VRE in a murine model

“…Phages offer several theoretical advantages over antibiotics including increased specificity towards the target pathogen, self-dosing behavior, and an abundance of phages that can be isolated easily from environmental sources [16,17]. In the United States, phage therapy has been used in emergency use settings and early phage clinical trials targeting infections caused by Enterococcus faecium, Acinetobacter baumannii, Pseudomonas aeruginosa, and Mycobacterium abscessus, among other pathogens [18][19][20][21][22][23][24][25][26] Despite the recent increase in case reports indicating successful phage therapy usage, many questions remain regarding the safety and efficacy of this biological therapeutic. One such question focuses on the potential impact of the recipient's immune system on phage efficacy, particularly when the therapeutic is reused in the same individual.…”