Phage Therapy: The Forgotten Cure Making a Comeback

Introduction: The Age of Superbugs and a Century-Old Solution

Antibiotics used to transform medicine, but now their efficacies are disappearing. With antibiotic resistance on the rise, we are being forced to look back in time for forgotten answers. An answer for this? Phage therapy - a century-old microbial assassin that may rescue modern medicine. 

What are Bacteriophages?

If you didn't read our detailed article on these microbes, have a look at The Viral Side of Life: How Bacteriophages Rule the Microbial World. Phages or bacteriophages, are viruses that attack and eliminate only some specific strains of bacteria. While common antibiotics destroy both the good and the bad bacteria, phages only attack and kill the harmful ones. Therefore, they offer a bright chance to create personalized medicine for superbugs. 

Why Was Phage Therapy Abandoned?

Phage therapy first gained traction in the early 20th century, even before antibiotics. But due to: 

• Unpredictable results,
• Limited understanding of viruses, and 
• The explosive success of penicillin in the 1940s, phage therapy fading from mainstream medicine, except in places like Georgia and Russia, where it quietly continued 

Why is it Making A Comeback?

Since there are more treatment-resistant infections and not many new antibiotics coming up, phage therapy is again being considered by experts and medical practitioners. What has changed?

• Advances in genome sequencing allow rapid phage identification
• Synthetic biology helps engineer "super phages" with enhanced killing power
• Successful clinical trials and last-resort treatments are showing remarkable recovery stories

Case in Point: Real-World Success Stories

Phage therapy is not science fiction - it is already saving lives

• UK Miracle Case: A teenage girl suffering from a nearly untreatable Mycobacterium abscessus infection post-lung transplant was given genetically engineered phages as a last resort. Her condition dramatically improved, marking one of the first life-saving uses of modified phages in humans [Link: https://pubmed.ncbi.nlm.nih.gov/31068712/]
• US Phage Cocktails in Action: A team of researchers is busy using phage cocktails to fight multidrug-resistant strains of Pseudomonas aeruginosa and Klebsiella pneumoniae, which are known to cause severe hospital-acquired infections. Early results from compassionate use cases are showing promising outcomes [Link: https://www.nature.com/articles/s41598-023-36034-2, https://www.nature.com/articles/s41522-024-00603-8]

These are not isolated incidents - they are signals that phage therapy may soon shift from experimental to essential in mainstream medicine 

The Precision Advantage

Phages: 

• Spare beneficial gut bacteria
• Multiply at the infection site
• Co-evolve with bacteria, reducing resistance buildup
• Can be genetically modified to enhance performance

Unlike static antibiotics, phages adapt. That makes them not just a treatment, but an evolving ally in our microbial battle.

Figure A: Diagrammatic representation of the use of Phage Therapy against Antibiotic Resistance [Image courtesy: ChatGPT]

Challenges to Watch

Despite the promise, phage therapy still faces hurdles:

• Regulatory ambiguity
• Complex manufacturing & storage
• Need for personalized phage-bacteria matching

Yet, startups and research groups in biotech are trying to make it easier and faster for products to be approved and produced. 

Looking Ahead: Will Phages Replace Antibiotics?

Probably not entirely. But in combination with antibiotics or on their own for resistant infections, phages could become an essential part of 21st-century infectious disease medicine. 

As precision medicine becomes more common, phage therapy gives us a customized, lasting, and scalable solution to counter the increase in superbugs.  

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"Tiny Defenders: How Antimicrobial Peptides Are Shaping the Future of Medicine"

                                                    

                                                                                                                                  - The Microbe Maven