Phage therapy in the fight against antibiotic resistance
Phage therapy is the process of using bacterial viruses (phages) to treat bacterial infections. The practice itself has been around for over a century, however an Australian team only recently demonstrated the safety of using phage therapy to combat infection in the setting of very severe sepsis and shock.
Professor Jonathan Iredell is an infectious diseases physician and clinical microbiologist at the Centre for Infectious Diseases and Microbiology at Westmead Hospital and leads the Critical Infection research team at the Westmead Institute for Medical Research.
“Phage therapy was largely eclipsed by the emergence of antibiotics, however, is now experiencing a comeback due to the rise of antibiotic resistance as a global health threat. Its activity against antibiotic-resistant pathogens and lack of serious side effect makes it an attractive alternative to antibiotics.
“Our research showed that it is safe to use phage therapy on someone who is seriously ill in intensive care, which until now has been an important question regarding its use. We were also able to show that phage therapy may have a modulating effect on the inflammatory response, itself a major cause of death in severe infection. We were also able to measure the number of viruses present in the blood, how the body clears them, and how that relates to the number of bacteria in the blood,” said Prof Iredell.
Phages are the most common biological entities in nature and when all antibiotics fail, can still succeed in killing bacteria and save a life from infection.[1] Until now phage therapy has been used mostly empirically and rarely in a systematic trial setting.
“The advantage of phage therapy is that it is effective against bacteria which has developed antibiotic resistance. It also appears to work together with antibiotics, making their effects more powerful and could therefore make all the difference towards successful therapy. What’s more, phage therapy appears to be very safe and well tolerated by the body without the toxicities that we normally associate with antibiotics, such as damage to the liver or kidneys.
“The main need is now to make the viruses more available by establishing collections of those that kill the most important bacteria, developing the correct diagnostic tools and defining how best to use them,” said Prof Iredell.
The research is an ongoing collaboration between Westmead Hospital, the Childrens Hospital at Westmead, the University of Sydney, the Westmead Institute of Medical Research, and like-minded experts at multiple centres in Sydney, Melbourne, Brisbane, Adelaide, Perth, and around the world.
