Phage Therapy—Challenges, Opportunities and Future Prospects

Abstract

The increasing drug resistance of bacteria to commonly used antibiotics creates the need to search for and develop alternative forms of treatment. Phage therapy fits this trend perfectly. Phages that selectively infect and kill bacteria are often the only life-saving therapeutic option. Full legalization of this treatment method could help solve the problem of multidrug-resistant infectious diseases on a global scale. The aim of this review is to present the prospects for the development of phage therapy, the ethical and legal aspects of this form of treatment given the current situation of such therapy, and the benefits of using phage products in persons for whom available therapeutic options have been exhausted or do not exist at all. In addition, the challenges faced by this form of therapy in the fight against bacterial infections are also described. More clinical studies are needed to expand knowledge about phages, their dosage, and a standardized delivery system. These activities are necessary to ensure that phage-based therapy does not take the form of an experiment but is a standard medical treatment. Bacterial viruses will probably not become a miracle cure—a panacea for infections—but they have a chance to find an important place in medicine.

Isolation, characterization and therapeutic evaluation of a new Acinetobacter virus Abgy202141 lysing Acinetobacter baumannii

“…However, phage therapy has limitations including variation among clinical pathogens in resistance to phages, and host immune response to phage (Hatfull et al, 2022 ). Therefore, with these considerations, phage therapy is commonly used as a last resort in response to complete antibiotic failure (Hatfull et al, 2022 ), and a major advantage of phage therapy is treatment of MDR bacteria (Zalewska-Piatek, 2023 ). Moreover, the phages utilized in combination with antibiotics have been associated with successful microbiological and clinical responses, when traditional antimicrobial therapy have failed (Schooley et al, 2017 ; Chan et al, 2018 ; Hatfull et al, 2022 ).…”

PluMu - a Mu-like bacteriophage infectingActinobacillus pleuropneumoniae

“…There has been a resurgence of interest in the use of phage therapy as a strategy to treat bacterial infections, especially those caused by antimicrobial-resistant (AMR) bacteria [38]. A. pleuropneumoniae AMR is an increasing problem [6].…”

Bacteriophages as a potential substitute for antibiotics: A comprehensive review

“…Though phage therapy is not currently approved in many countries, advancements in this field could potentially revolutionize the field of medicinal science in the future. 7…”

“…10 (6) Target overexpression: Overexpression of the genes encoding the drug's molecular targets can sometimes lead to resistance to growth-inhibitory drugs. 11 (7) Target modification or protection: Target modification may occur due to mutations in the gene encoding the antibiotic protein target or enzymatic changes to the binding site. 8 When target bypass occurs, a new protein takes over the function of the antibiotic target, rendering the original target unusable and the antibiotic ineffective.…”