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.

Keywords: antibiotic resistance; bacteriophages; clinical trials; infectious disease; phage therapy.

Figure 1

Human phage therapy trials and the range of target sites/infections. Image adapted from Furfaro et al. [46].

Figure 2

Personalized combinatorial phage therapy. Image adapted from Akanda et al. [62].