Success in the fight against multi-drug resistant pathogens

Researchers at the University of Pittsburgh have developed new drug therapies that have been successful against mycobacterial infections previously untreatable with conventional antibiotics.

Two patients were treated with bacteriophage therapy and have since gone on to make full recoveries. Bacteriophages are genetically modified viruses that can selectively infect bacterial hosts and cause lysis. The first patient, a 26-year-old with cystic fibrosis, had suffered with a chronic lung infection for six years and the second, a 56-year-old man on immunotherapy for arthritis, had a severe skin infection. The mycobacterium didn’t acquire resistance to the phage therapy and although there was a partial anti-phage antibody response, the mycobacterium was completely eradicated in both cases. Phage technology has previously been used in compassionate cases but there are yet to be any clinical trials or approval for licensed use.

Multi-drug resistant microbes are rapidly emerging with the overuse and misuse of antibiotics in both the farming industry and with the over prescription of antibiotics. The world health organisation has declared antibiotic resistance to be one of the biggest threats to global health, food security and development. Globally, millions of people each year die directly as a result of antimicrobial resistant infections and is a contributing factor to millions more deaths.

With the advent of these drugs, the use of combination therapy to target resistant strains of pathogens will become more successful. It will allow for shorter courses of treatment with lower doses of antibiotics, reducing the toxicity of the treatment.

Whilst there have so far been promising results using this new class of drugs, there are still many barriers to approved use. Clinical trials are yet to start to test for efficacy and safety. And there is always the possibility of phage-resistant bacteria emerging.