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Comment by coryrc | Hacker News Reader

Because you'll end up finding bacteriophages and wonder why we're wasting so many lives and much money on antibiotics.

Antibiotics are lazy. Sure, some people have to die, but at least you didn't have to spend any time taking samples of the actual infection.

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Bacteriophages suck. What some people never tell you is that the body treats phages as invaders and can very effectively get rid of them, they are not adapted to the human environment. These are only good for local treatments, sometimes...

that seems like a good thing. they only infect bacteria, not humans

phages are found in large quantities in mucus, where they seemingly contribute to the barrier function of mucus by preying on any bacteria that try go cross

https://pubmed.ncbi.nlm.nih.gov/23690590/

https://www.pnas.org/doi/10.1073/pnas.1508355112

https://journals.asm.org/doi/10.1128/mbio.01984-19

this might be adaptable for therapeutics

https://www.nature.com/articles/s41467-024-48560-2

https://www.nature.com/articles/s42003-024-07269-0

Well, you actually want the body to clear things. That’s not a problem, it’s a feature. If the phage is able to target the bacteria before it is fully cleared, that’s all you need. Humans have been injected with phages and it has been shown to work. The Soviets actually did a lot of research on it, IIRC. The practical issue that is really challenging for broad phage therapy adoption is that phages are very specific to the bacteria they target. So, you can’t just get injected with any old phage and expect it to work. Instead, you need to catalog all the phages you find in a database and search for one that can target the specific bacteria the patient has been infected with. Phages are simply viruses that target bacteria. You’re awash in them all the time.

It's a good thing, unless the body clears off the phage first, leading to both reduced effectiveness and the body wasting immune resources. It does work locally, and one can probably engineer it today to work even better. But it seems to be destined to be relegated to a secondary cure. We seem to be able to keep finding new antibiotics with benefits like 'massive safety testing' or 'we know exactly how they work', or 'very easy to administer'.

>you need to catalog all the phages you find in a database and search for one that can target the specific bacteria the patient has been infected with.

Most of the time the doctor doesn't know the exact pathogen you are infected with. He'll suspect a bacterian infection of some kind and prescribe a wide range antibiotic.

Doing what you suggest will require changing the way we do medicine. Which might not be a bad thing but requires some determination.

This is correct, it's called empiric treatment. If a patient comes in with altered mental status and neck rigidity, you don't have time to take a lumbar puncture and culture bacteria. I don't know anything about phage treatment, but from what the other commenter said, it seems like then you'd have to do some sort of PCR test as well. You simply don't have time for any of that -- your only choice is to blast them with vancomycin + ceftriaxone.

Yeah, which is why we need to stop using antibiotics for cases where we could use phage treatment.

Wait what

If you come into ED with GGP's symptom's, you might only have an hour to live. Hopefully for you it's bacterial and didn't pick up resistance from horizontal transference from a strep throat treatment that's trivial to culture and, while unpleasant, can wait a few hours to start treatment while the correct bacteriophage is readied.

Feels like it might be more practical to simply distribute phage therapy to a whole population targeting a known pathogen, like this year’s cold strain. Especially of the goal is just to reduce the use of antibiotics, not eliminate.

"Common cold" is a virus. Vaccines train your immune system to fight things.

Bacteriophages fight bacteria. They actually do the fighting. They are quickly cleared by the body, so they are useless for prevention.

The really big issue is that there isn't enough money in it, there is no way to get an exclusive.

It should be promoted by governments.

To expand on what you wrote, the challenge with phages is that they’re highly specific to certain bacteria, in the same way that some viruses target gorillas and some target humans. We have yet to find broad spectrum phages. While humans have been saved from bacteria by phages, it requires identifying the bacteria strain, looking up appropriate phage that can target that bacteria, cultivating a dose of the phage, etc. So, yea, phages are highly effective, but there are practical challenges. As you say, antibiotics are lazy.

Ok, another naive question: Not suggesting we just eat a bunch of bacteriophages, but why wouldn't studying phage mechanisms / proteins for killing bacteria be equally useful?

This is being studied. Phage research is active.

We need to implement it! Steffanie Strathdee could save her husband's life because she was the director of UC San Diego’s Global Health Institute. "Regular" people deserve to live too.

https://www.buzzfeednews.com/article/azeenghorayshi/navy-pha...

I'm sure people are studying them. But as GP said, antibiotic are lazy. A doctor would much rather prescribe an antibiotic than do the work to match the specific bacterial infection with the particular phage to deal with it.

And since antibiotics still work (for now), there's not all that much money in phage research. If we do get to the point where we "run out" of antibiotics due to bacterial resistance, I imagine phage research will become a lot more attractive as a destination for research funding.

They're viruses, so they work by infecting bacteria and making the bacteria create more of itself.

Antibiotics are found by isolating a compound some i.e. fungi naturally produces. We figure out how to produce the compound and don't fill people with fungi to produce it. Bacteriophages are already the analogy to the compound itself.

So we should be investing heavily in creating and distributing all variety of bacteriophage for all our common bacterial infections. 20k deaths/year from MRSA in the USA alone, 120k infections/year in USA and many of the survivors are left with life-long complications.

The problem is, phages are recognized by your immune system too. They're effectively single-shot, last ditch efforts.

Thank you so much for volunteering!

Hey @rscho I saw a comment of yours from a few months ago on this site and I want to get a hold of you, I didn't know a better way than replying to your latest comment.

Can you message me on discord? username: tag_durden If you have a better contact method let me know i just didnt wanna put my email out here.

I don't use discord. raoul.schorer@gmail.com

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