MadSci Network: Microbiology

Re: Why don't we use phage medicines?

Date: Wed May 13 00:39:45 1998
Posted By: David Beck, MadSci Admin
Area of science: Microbiology
ID: 894894094.Mi

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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