Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022:3:100115.
doi: 10.1016/j.crmicr.2022.100115. Epub 2022 Feb 16.

Phage therapy in the Covid-19 era: Advantages over antibiotics

Atif Khan  1   2 , T Subba Rao  1   2 , Hiren M Joshi  1   2
Affiliations
Review

Phage therapy in the Covid-19 era: Advantages over antibiotics

Atif Khan et al. Curr Res Microb Sci. 2022.

Abstract

Today, the entire world is battling to contain the spread of COVID-19. Massive efforts are being made to find a therapeutic solution in the shortest possible time. However, the research community is becoming increasingly concerned about taking a shortsighted strategy without contemplating the long-term consequences. For example, It has been reported that only 8.4% of total COVID-19 patients develop a secondary bacterial infection. In comparison, 74.6% of them are administered with antibiotics as prophylactic treatment. We contend that overuse of broad-spectrum antibiotics increases the likelihood of AMR development and negatively affects the patient's recovery due to the prevalence of the "gut-lung axis.". Consequently, the use of antibiotics to treat COVID-19 patients must be rationalized, or an alternative treatment must be sought that does not risk contributing to AMR development and positively impacts the treatment outcomes. Phage therapy, a century-old concept, is one of the most promising approaches that can be adapted to serve this purpose. This review emphasizes the negative impact of excessive antibiotic use in COVID-19 treatment and provides an overview of how phage therapy can be used as an alternative treatment option. We have argued that targeted killing (narrow spectrum) and anti-inflammatory (which can target the primary cause of mortality in COVID-19) properties of phages can be an effective alternative to antibiotics.

Keywords: Antibiotics; Bacteriophages; Cytokines; Immunomodulation; Multidrug resistance; SARS-CoV-2.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Image, graphical abstract
Graphical abstract
Fig. 1
Fig. 1
A schematic illustration showing the infection of SARS-CoV-2 in alveolar cells, causing secondary bacterial infections.
Fig. 2
Fig. 2
Comparative advantages of Phage therapy over antibiotics for treating secondary bacterial infection.
Fig. 3
Fig. 3
Interaction of bacteriophages with our immune system . A) Inhibition of NF-κB mediated expression of pro-inflammatory cytokines, B) Inhibition of ROS generation, C) Inhibition of expression of TNF via Toll-like receptors, D) Induction of Type 1 interferon via Toll-like receptor, E) Direct binding to LPS and F) non–host-derived immunity via Bacteriophage Adherence to Mucus.
See this image and copyright information in PMC

References

    1. Barr J.J., Auro R., Furlan M., Whiteson K.L., Erb M.L., Pogliano J., Stotland A., Wolkowicz R., Cutting A.S., Doran K.S., Salamon P., Youle M., Rohwer F. Bacteriophage adhering to mucus provide a non-host-derived immunity. Proc. Natl. Acad. Sci. U. S. A. 2013;110:10771–10776. doi: 10.1073/pnas.1305923110. - DOI - PMC - PubMed
    1. Batinovic S., Wassef F., Knowler S.A., Rice D.T.F., Stanton C.R., Rose J., Tucci J., Nittami T., Vinh A., Drummond G.R., Sobey C.G., Chan H.T., Seviour R.J., Petrovski S., Franks A.E. Bacteriophages in Nat. Artificial Environ. Pathog. Basel Switz. 2019;8:100. doi: 10.3390/pathogens8030100. - DOI - PMC - PubMed
    1. Becattini S., Taur Y., Pamer E.G. Antibiotic-induced changes in the intestinal microbiota and disease. Trends Mol. Med. 2016;22:458–478. doi: 10.1016/j.molmed.2016.04.003. - DOI - PMC - PubMed
    1. Belkaid Y., Hand T.W. Role of the microbiota in immunity and inflammation. Cell. 2014;157:121–141. doi: 10.1016/j.cell.2014.03.011. - DOI - PMC - PubMed
    1. Beović B., Doušak M., Ferreira-Coimbra J., Nadrah K., Rubulotta F., Belliato M., Berger-Estilita J., Ayoade F., Rello J., Erdem H. Antibiotic use in patients with COVID-19: a 'snapshot' infectious diseases international research initiative (ID-IRI) survey. J. Antimicrob. Chemother. 2020 doi: 10.1093/jac/dkaa326. - DOI - PMC - PubMed

LinkOut - more resources