Can anyone comment on using phages to kill bacteria. I read the this was developed extensively in Russia during the Cold War.
Phage therapy is neat, it really is, but there are a couple major issues:
- There is no such thing as a "broad spectrum" phage. You can't do empirical treatment using phages, and there's not really "off the shelf" phage therapy - it tends to be a bespoke creation for a particular infection.
- There's some serious regulatory problems, similar to those experienced by fecal transplant treatments. We're not yet really equipped to think about handling evolving, custom microbes as a treatment. - Because of the first, it's going to require a considerable amount more lab capacity than most clinical settings currently have, and considerable delays until treatment.
- There's also some biosafety issues around phage prep, but those are easily solvable. It's a great way to treat particularly resistant or hard to treat infections, but it's not a particularly great general solution. There's a reason it was abandoned in countries with easy access to antibiotics - they're just roundly superior in basically every respect.
There were also attempts at intravenous administration of phages, but I am not sure about safety concerns there (rapid lysis of bacteria resulting in a toxic shock, excessive antiviral response of the immune system and purification of phages all come to mind).
Short overview: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3400130/?report...
Somewhat longer (PDF): https://www.researchgate.net/profile/Sarah_Kuhl2/publication...