For some illnesses, your doctor will prescribe antibiotics, right? They are usually the main medicine we use for bacterial infections. But sometimes, no matter what antibiotic we give, we can get resistant to them, and dangerous bacteria (we also call these 'superbugs') can enter our bodies. So what do we do in times like these? Today we are going to talk about a somewhat strange but very powerful treatment that can help in times like these. That is Phage Therapy.
Simply put, what is Phage Therapy?
Phage or bacteriophage is a type of virus. Don't be afraid to ask, "Is it a virus?" This is not a virus like Corona or Dengue that makes us sick. The only target and only food of these phage viruses is bacteria. They do not harm human cells. Think of it like a special commando trained to hunt bacteria.
Phage is not a man-made virus. It is naturally present everywhere in the world - in soil, water, and, surprisingly, in your body. So, phage therapy involves using this phage virus, which is a special 'enemy' of that bacteria, to fight a bacteria that even antibiotics cannot kill.
So how does this treatment work?
This is a very interesting natural process. A phage virus cannot reproduce on its own, that is, multiply. It definitely needs a bacterium to do so.
1. Target recognition: First, the phage virus finds a specific bacterium it can destroy and attaches itself to its surface.
2. Inserting the DNA: Next, the phage virus injects its genetic information, that is, DNA, into the bacterial cell.
3. Taking control: The bacterial cell is now completely under the control of the phage virus. Using all the energy of the bacteria, it begins to make hundreds of new phage viruses using the DNA that has entered.
4. Destruction and spread: When there is no more room inside the bacterial cell for new phage viruses to form, the bacterial cell bursts. Then, hundreds of thousands of those newly formed phage viruses come out, find other bacteria, and start the cycle of destroying them as well.
Doctors use this method in the following way: They identify the exact bacteria that is causing the infection in your body. Then, from a 'phage library' of thousands of different phages, they select the exact phage that attacks that bacteria and use it for treatment.
Some research has found that phage therapy, when combined with existing antibiotics, enhances the effectiveness of those antibiotics.
There are several situations where this treatment may help:
- Lung infections associated with cystic fibrosis
- Ear infections caused by the bacteria P. aeruginosa
- Other infections caused by E. coli or P. aeruginosa bacteria
- Infections of non-healing leg ulcers
- Bacterial eye infections
- Sepsis (blood infection) in newborns
- Urinary tract infections
- Wound infections after surgery
What are the advantages and disadvantages of phage therapy?
Like any treatment, this one has benefits and some risks. Let's look at both. Let's talk about the benefits first.
| Benefit | Description |
|---|---|
| Specific goal | When we use antibiotics, they kill both the bad bacteria and the good bacteria that are good for our bodies. But phage therapy is very specific. It only targets the bad bacteria that are causing the infection. So there is very little damage to other cells in the body or the good bacteria. |
| Large supply | If a bacterium becomes resistant to an antibiotic, the other antibiotics we have to use are limited. But there are millions of phages in nature. If one phage becomes ineffective, there is a good chance that another phage will be found that is more suitable for the same bacteria. |
| Quick production | It takes years to develop a new antibiotic, but a phage therapy that is suitable for a patient's infection can be identified and matched within days. That means treatment can begin sooner. |
Can this cause harm? What are the risks?
There are several things that doctors are concerned about when talking about this treatment.
- Lack of sufficient information: Although phage therapy has been used for some time in countries like Russia and Poland, large, modern clinical trials at the global level are still in their early stages. Therefore, there is not enough data to say with 100% certainty what the short-term and long-term side effects of this treatment are.
- Septic Shock Risk: This is the main risk. When phage viruses rapidly break down bacterial cells, toxic substances called endotoxins inside those cells can be released into the body. These can affect the immune system, cause blood pressure to drop suddenly, and cause organ failure. But remember, this risk is the same when using strong antibiotics.
- The risk of DNA transfer: Phage viruses can naturally transfer DNA from one bacterium to another. So some people believe that this DNA transfer could lead to the creation of new, dangerous strains of bacteria. But there is no need to worry, because scientists carefully screen the phages used in this treatment and only select those that do not contain toxins or harmful genes.
Is this treatment available in Sri Lanka?
At this point, phage therapy has not yet become a mainstream treatment in many countries around the world, including Sri Lanka. It is still in the research stage, or falls under the category of "compassionate use." This means that doctors can only administer this treatment in emergencies, when all other approved treatments have failed and there is no other option to save a life , with special permission.
This treatment method is actually more than 100 years old. Although it was widely used even in America in the 1940s, it gradually died out with the discovery of antibiotics. But now that the problem of antibiotic-resistant bacteria has become a major threat to the world, there has been a renewed interest in phage therapy. Therefore, research on this is happening rapidly around the world.
Take-Home Message
- Phage therapy is the use of a special type of virus (phage) to destroy bacteria.
- This could be a very important solution in the future for severe infections such as antibiotic-resistant 'superbugs'.
- Because this treatment specifically attacks only bad bacteria, there is very little harm to the beneficial bacteria in the body.
- This is still in the research stage in many countries around the world and has not yet been approved for general use.
- If you or a loved one has a persistent, long-term bacterial infection, the best thing to do is to talk to your doctor and discuss all available treatment options.
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