|MadSci Network: Microbiology|
Well, it could be academic snobbery, but practical matters drive the market of what is considered a reasonbale therepeutic agent. 1. Most the time we do not know the causitive agent when we begin treatment of a disease. Practically this means that since a phage is specific to certain types of bacteria and we have antibiotics that work on many types of bacteria you would prefer to treat with the antibiotics first. 2. Lawsuits. Antibiotics are proven to be effective. If you give the wrong antibiotic you are likely not going to be sued as long as you have a resonable suspicion that that antibiotic would normally work. If you give the wrong phage all bets are off, it won't work anyway. 3. Licensing. Licensing is controlled by various governing bodies. Before a new drug, or treatment such as phage can be legally used you must get a license. The rules in each country are different, but generally speaking you must prove several things: a) the treatment is effective against the disease; b) the treatment is more cost effective than available treatments; c) there is a need for this treatment. There are studies from Russia, as well as from the United States showing that the use of phage for treatment of infectious disease is effective. But know one has invested significant amounts of time or many in Europe or the United States because currently the practical barriers are insermountable for most disease states. There are very few cases where such treatment could be considered needed, and more cost effective than current treatments. A few I can think of are AIDS, several groups are developing phage that specifically target HIV infected cells. Not using phage, but using real human viruses that have been modified to infect only HIV infected cells. A second one is the treatment of cattle. That is where the current research in the the United States is being done. It is much easier to get a treatment approved for cattle than humans. A third one would be disease in which the infectious agent is known for sure. This is VERY few diseases. HIV is an example of a viral disease, and the few examples of bacterial diseases where the agent is known for sure are Cystic Fibrosis patients, they almost always progress to a Pseudomonas infection. Lyme disease, syphilis, tuberculosis. You will note that all of these diseases involve a long term carrier state. It is only this type of disease that you could ever get approval for the use of bacteriaphage. Best Wishes, David Beck
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