Abstract

In some scientific circles, the current time is referred to as the “post-antibiotic era” due to several multidrug-resistant bacterial infections. Thus, there is an immediate need for novel medicines and alternative therapies. Phages are the most abundant and ubiquitous organisms in the ecosystem. Phage therapy has shown promise as a therapeutic approach for managing antibiotic-resistant bacterial infections. Several studies have investigated phage therapy for systemic bacterial infections, highlighting the efficacy of phage therapy alone or with antibiotics to treat such bacterial infections. Research has also posited a rationale for phage therapy in managing local disorders, including burn wounds, otitis media, and urinary tract infections. Although prophylactic treatment with phage particles has shown potential in gastrointestinal infections, some researchers have suggested that preventive therapy is improbable.

In addition to chronic persistent diarrhea, other potential indications for fecal microbiota transplantation (FMT) include inflammatory bowel disease (IBD), obesity, and specific psychiatric disorders. FMT changes both the bacteria and phage populations. In one study, cystic fibrosis in mice caused byP. aeruginosa was eradicated following intranasal administration of two doses of phage particles after infection. Thus, there is a renewed interest in FMT and phage therapy. Despite the promising results of FMT in chronic diarrhea, the U.S. Food and Drug Administration (FDA) has issued a safety alert regarding treatment with FMT after reporting six patients who contracted enteropathogenic E. coli and Shiga toxin-producing E. coli (two patients died) after FMT. The FDA’s position is that FMT must meet investigational new drug administration standards for approval due to its theoretical safety concerns. As phages are biologicals and cannot satisfy the strict regulatory standards for approval of chemical drugs, such as antibiotics, obtaining regulatory approval is problematic.

Keywords: Antibiotic Resistance; Bacteriophage; Biodivergence; Fecal Transplant; Microbiota; Post-Antibiotic Era

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