Bacteriophages as Alternatives to Antibiotics in Clinical Care

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.

Characteristics of a Series of Three Bacteriophages Infecting Salmonella enterica Strains

“…Phage therapy is one of the most promising alternatives to treat patients suffering from infectious diseases caused by antibiotic-resistant bacteria [ 42 ]. However, apart from legal difficulties which currently impair formal possibilities of the common use of phage therapy in clinical practice [ 43 ], there are several microbiological issues which must be considered when applying such therapeutic procedures [ 44 ]. Particularly, the crucial requirements are as follows: ( i ) the presence of a large collection of bacteriophages, ( ii ) the use of virulent, rather than temperate, phages, ( iii ) the use of phages devoid of genes coding for toxins and other potential deleterious agents in their genomes.…”

Nanomedicine Fight against Antibacterial Resistance: An Overview of the Recent Pharmaceutical Innovations

“…However, up to date, none of the phage therapies have successfully extended its application to the consumers. The major drawbacks that hinder the application of this strategy include high specificity and poor pharmacokinetic properties [206].…”

Genetic Analysis and Characterization of a Bacteriophage ØCJ19 Active against Enterotoxigenic Escherichia coli

“…However, it is challenging to evaluate the genetic biosafety of the phages through these analyses. Recently, NGS has become a powerful tool to support these analyses, but the functions of the encoded phage genes are still unknown ( Romero-Calle et al, 2019 ). Therefore, functions of the unknown genes need to be studied further for safe use of phages.…”