Even though we use them every day, when you really think about it, antibiotics are miracle drugs. They go in and kill bacteria that could otherwise kill us.
However, antibiotics, for all of their miraculous nature, are not perfect. They are not specific in their targets, so they kill the “good” bacteria in addition to the bacteria causing the infection, and this impacts the microbiome. They can have adverse effects. And resistance to antibiotics is an issue.
So is there a better option?
This week, Pediatrics is early releasing a State of the Art Review by Drs. Nanda Ramchandar and John Bradley, MD, at Uniformed Services University, entitled “Clinical Application of Bacteriophage Therapy in Children” (10.1542/peds.2024-068838).
What is a bacteriophage? It’s a virus that infects bacteria, releasing viral DNA into the bacteria and eventually destroying the bacteria.
There are several advantages of bacteriophages:
- The bacteriophage population can only reproduce while there is a supply of the specific bacteria that it is targeting. Once the bacterial pathogen has been eradicated, the bacteriophages generally dissipate.
- Bacteriophages are very specific and can be individualized.
- There are no reports of bacteriophages that can bind to human tissue and cause symptoms, thus there are very few adverse events.
So why aren’t we using bacteriophages right now?
- Although there have been some clinical studies in adults, there are very limited pediatric studies.
- They have to be individualized to the specific bacteria that you are targeting, and that takes time. Thus, they are not readily available, except some very specific cases—for example, patients with late-stage cystic fibrosis and infections caused by multi-drug-resistant bacteria.
I hope that you will read this review of the history of the bacteriophage and learn about the huge future potential for this technology. I’m sure that we will hear more about the use of bacteriophages in the coming years.
