Review Article
Volume 8 Issue 2 - 2021
Could Phage Therapy be the Protector of Humankind?
Nicholas A Kerna1,2*, John V Flores3,4, Hilary M Holets3,4, Lawrence U Akabike5, Mark H Chen6, Emmaneulla Olubumni Solomon7, Kevin D Pruitt8, Uzoamaka Nwokorie9 and Shain Waugh10
1SMC–Medical Research, Thailand
2First InterHealth Group, Thailand
3Beverly Hills Wellness Surgical Institute, USA
4Orange Partners Surgicenter, USA
5Larrico Enterprises, LLC, USA
6For Your Health, LLC, USA
7Obafemi Awolowo University, Nigeria
8Kemet Medical Consultants, USA
9University of Washington, USA
10Fettle Path, USA
*Corresponding Author: Nicholas A Kerna, (mailing address) POB47 Phatphong, Suriwongse Road, Bangkok, Thailand 10500.
Received: December 28, 2020; Published: January 27, 2021


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


  1. Pirnay JP., et al. “The Magistral Phage”. Viruses 10 (2018): 64.
  2. Lin DM., et al. “Phage therapy: An alternative to antibiotics in the age of multi-drug resistance”. World Journal of Gastrointestinal Pharmacology and Therapeutics 8 (2017): 162-173.
  3. Press Briefing Transcript: CDC Telebriefing on Today’s Drug-Resistant Health Threats (2013).
  4. Rice LB. “Federal funding for the study of antimicrobial resistance in nosocomial pathogens: No ESKAPE”. The Journal of Infectious Diseases 197 (2008): 1079-1081.
  5. Comeau AM., et al. “Exploring the prokaryotic virosphere”. Research in Microbiology 159 (2008): 306-313.
  6. Weinbauer MG. “Ecology of prokaryotic viruses”. FEMS Microbiology Reviews 28 (2004): 127-181.
  7. Dublanchet A and Bourne S. “The epic of phage therapy”. Canadian Journal of Infectious Diseases and Medical Microbiology 18 (2007): 15-18.
  8. Summers WC. “Bacteriophage therapy”. Annual Review of Microbiology 55 (2001): 437-451.
  9. Twort FW. “An Investigation on the Nature of Ultra-Microscopic Viruses”. Lancet 186 (1915): 1241-1243.
  10. Hankin EH. “L’action bactericide des eaux de la Jumna et du Gange sur le vibrion du cholera (in French)”. Annales de l'Institut Pasteur 10 (1896): 511-523.
  11. Abedon ST., et al. “Bacteriophage prehistory: Is or is not Hankin, 1896, a phage reference?” Bacteriophage 1 (2011): 174-178.
  12. Suttle CA. “Viruses in the sea”. Nature 437 (2005): 356-361.
  13. Suttle CA. “Viruses: Unlocking the greatest biodiversity on Earth”. Genome 56 (2013): 542-544.
  14. Brum JR., et al. “Ocean plankton. Patterns and ecological drivers of ocean viral communities”. Science 348 (2015): 1261498.
  15. Breitbart M., et al. “Phage puppet masters of the marine microbial realm”. Nature Microbiology 3 (2018): 754-766.
  16. Anisimov AP and Amoako KK. “Treatment of plague: Promising alternatives to antibiotics”. Journal of Medical Microbiology 55 (2006): 1461-1475.
  17. Manrique P., et al. “The Human Gut Phage Community and Its Implications for Health and Disease”. Viruses 9 (2017): 141.
  18. Kutter E., et al. “Phage therapy in clinical practice: Treatment of human infections”. Current Pharmaceutical Biotechnology 11 (2010): 69-86.
  19. Villaroel J., et al. “Metagenomic Analysis of Therapeutic PYO Phage Cocktails from 1997 to 2014”. Viruses 9 (2017): 328.
  20. Quinn R. “Rethinking antibiotic research and development: WorldWar II and the penicillin collaborative”. American Journal of Public Health 103 (2013): 426-434.
  21. Fleming A. “Penicillin’s finder assays its future”. The New York Times (1945): A21.
  22. STREPTOMYCIN treatment of pulmonary tuberculosis”. British Medical Journal 4582 (1948): 769-782.
  23. I Samson. “A new class of antimycobacterial drugs: the diarylquinolines”. Thorax 6 (2005): 495.
  24. Ling LL., et al. “A new antibiotic kills pathogens without detectable resistance [published correction appears in Nature”. Nature 7535 (2015): 455-459.
  25. Hover BM., et al. “Culture-independent discovery of the malacidins as calcium-dependent antibiotics with activity against multidrug-resistant Gram-positive pathogens”. Nature Microbiology 4 (2018): 415-422.
  26. Fair RJ and Tor Y. “Antibiotics and bacterial resistance in the 21st century”. Perspectives in Medicinal Chemistry 6 (2014): 25-64.
  27. Pires DP., et al. “Genetically Engineered Phages: a Review of Advances over the Last Decade”. Microbiology and Molecular Biology Reviews 3 (2016): 523-543.
  28. Kortright KE., et al. “Phage Therapy: A Renewed Approach to Combat Antibiotic-Resistant Bacteria”. Cell Host and Microbe 2 (2019): 219-232.
  29. Watanabe R., et al. “Efficacy of bacteriophage therapy against gut-derived sepsis caused by Pseudomonas aeruginosa in mice”. Antimicrobial Agents and Chemotherapy 2 (2007): 446-452.
  30. Capparelli R., et al. “Experimental phage therapy against Staphylococcus aureus in mice”. Antimicrobial Agents and Chemotherapy 8 (2007): 2765-2773.
  31. Biswas B., et al. “Bacteriophage therapy rescues mice bacteremic from a clinical isolate of vancomycin-resistant Enterococcus faecium”. 70.1 (2002): 204-210.
  32. Cerveny KE., et al. “Phage therapy of local and systemic disease caused by Vibrio vulnificus in iron-dextran-treated mice”. Infection and Immunity 11 (2002): 6251-6262.
  33. McVay CS., et al. “Phage therapy of Pseudomonas aeruginosa infection in a mouse burn wound model”. Antimicrobial Agents and Chemotherapy 6 (2007): 1934-1938.
  34. Dufour N., et al. “Bacteriophage LM33_P1, a fast-acting weapon against the pandemic ST131-O25b:H4 Escherichia coli clonal complex”. Journal of Antimicrobial Chemotherapy 11 (2016): 3072-3080.
  35. Nale JY., et al. “Get in Early'; Biofilm and Wax Moth (Galleria mellonella) Models Reveal New Insights into the Therapeutic Potential of Clostridium difficile Bacteriophages”. Frontiers in Microbiology 7 (2016): 1383.
  36. Yen M., et al. “A cocktail of three virulent bacteriophages prevents Vibrio cholerae infection in animal models”. Nature Communications 8 (2017): 14187.
  37. Galtier M., et al. “Bacteriophages Targeting Adherent Invasive Escherichia coli Strains as a Promising New Treatment for Crohn's Disease”. Journal of Crohn's and Colitis 7 (2017): 840-847.
  38. Waters EM., et al. “Phage therapy is highly effective against chronic lung infections with Pseudomonas aeruginosa”. Thorax 7 (2017): 666-667.
  39. Morello E., et al. “Pulmonary bacteriophage therapy on Pseudomonas aeruginosa cystic fibrosis strains: first steps towards treatment and prevention”. PLoS One2 (2011): e16963.
  40. Semler DD., et al. “Aerosol phage therapy efficacy in Burkholderia cepacia complex respiratory infections”. Antimicrobial Agents and Chemotherapy 7 (2014): 4005-4013.
  41. Huff WE., et al. “Therapeutic efficacy of bacteriophage and Baytril (enrofloxacin) individually and in combination to treat colibacillosis in broilers”. Poultry Science 12 (2004): 1944-1947.
  42. Oechslin F., et al. “Synergistic Interaction Between Phage Therapy and Antibiotics Clears Pseudomonas Aeruginosa Infection in Endocarditis and Reduces Virulence”. The Journal of Infectious Diseases 5 (2017): 703-712.
  43. Broecker F., et al. “Analysis of the intestinal microbiome of a recovered Clostridium difficile patient after fecal transplantation”. Digestion 88 (2013): 243-251.
  44. Broecker F., et al. “Stable core virome despite variable microbiome after fecal transfer”. Gut Microbes 8 (2017): 214-220.
  45. Broecker F., et al. “Long-term changes of bacterial and viral compositions in the intestine of a recovered Clostridium difficile patient after fecal microbiota transplantation”. Cold Spring Harbor Molecular Case Studies 2 (2016): a000448.
  46. Zhang F., et al. “Should we standardize the 1,700-year-old fecal microbiota transplantation?” The American Journal of Gastroenterology 107 (2012): 1755.
  47. Critical views in gastroenterology andhepatology: Fecal microbiota transplantation: Where is it leading? Gastroenterol”. Journal of Hepatology 10 (2014): 307-309.
  48. Fecal Microbiota for Transplantation: Safety Alert. U.S. Food and Drug Administration (2020).
  49. Filip M., et al. “Fecal transplantation: Digestive and extradigestive clinical applications”. Clujul Medical 91 (2018): 259-265.
  50. Ott SJ., et al. “Efficacy of Sterile Fecal Filtrate Transfer for Treating Patients with Clostridium Difficile Infection”. Gastroenterology 152 (2017): 799-811.
  51. Ma Y., et al. “A human gut phage catalog correlates the gut phageome with type 2 diabetes”. Microbiome 6 (2018): 24.
  52. Nguyen S., et al. “Bacteriophage Transcytosis Provides a Mechanism to Cross Epithelial Cell Layers”. MBio 8 (2017): 01874-01817.
  53. Ridaura VK., et al. “Gut microbiota from twins discordant for obesity modulate metabolism in mice”. Science 341 (2013): 1241214.
  54. Ley RE., et al. “Obesity alters gut microbial ecology”. Proceedings of the National Academy of Sciences of the United States of America 102 (2005): 11070-11075.
  55. Turnbaugh PJ., et al. “An obesity-associated gut microbiome with increased capacity for energy harvest”. Nature 444 (2006): 1027-1031.
  56. Wright A., et al. “A controlled clinical trial of a therapeutic bacteriophage preparation in chronic otitis due to antibiotic-resistant Pseudomonas aeruginosa; a preliminary report of efficacy”. Clinical Otolaryngology 4 (2009): 349-357.
  57. Sarker SA., et al. “Oral Phage Therapy of Acute Bacterial Diarrhea With Two Coliphage Preparations: A Randomized Trial in Children From Bangladesh”. EBio Medicine 4 (2016): 124-137.
  58. Jault P., et al. “Efficacy and tolerability of a cocktail of bacteriophages to treat burn wounds infected by Pseudomonas aeruginosa (Phago Burn): a randomised, controlled, double-blind phase 1/2 trial”. The Lancet Infectious Diseases 1 (2019): 35-45.
Citation: Kerna NA, Flores JV, Holets HM, Akabike LU, Chen MH, Solomon EO, Pruitt KD, Nwokorie U, Waugh S. “Could Phage Therapy be the Protector of Humankind?”. EC Gastroenterology and Digestive System 8.2 (2021): 104-113.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

April Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the April issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before April 26, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to