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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...

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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.

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

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