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Old therapy helps against antibiotic resistance

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Old therapy fights bacterial infections with special viruses. It has fallen into oblivion but is now being rediscovered due to the crisis of antibiotic resistance.

Little Wael owes his life to a horde of viruses. When he was one year old, he suffered from an infection with antibiotic-resistant bacteria. "He was given antibiotics day and night," says his mother, Khadidja Rezig, "Everything was tried, nothing helped."

Wael had a fever, his stomach was swollen with abscesses in his liver. Doctors have taken up exotic treatment, phage therapy. It is based on an amazing principle: special viruses that kill bacteria but leave people alone. These viruses are called phages.

Billions of phages in the blood

Billions of phages are infused directly into the bloodstream.
Phages enter the bacterium and inject their genetic material internally. There it outgrows the bacterial cell machinery by producing only new phages. Finally the bacterial sheath dissolves and young phages can hunt for new prey.

When a patient becomes infected, the phages disappear from the body, as there are no bacteria left to reproduce.

Antibiotics move the therapy phase

Shortly after he began treatment, Wael felt better: "He had no swelling and fever," his mother says. Wael was lucky: he was hospitalized in Brussels – Brussels is the focal point of phage therapy, which is rarely used differently.

The first patient was treated with phages 100 years ago, August 1, 1919. At the time when there were no antibiotics, this therapy was a great promise. It has been used in many countries over the decades, including in Switzerland.

However, with ambiguous results: some doctors have used them successfully, others have not. One reason was that science didn't know enough about phages at the time. When antibiotics emerged after World War II, phages were forgotten.

Modern studies are lacking

As there are more and more problems with antibiotic-resistant bacteria today, interest is growing again. But phage therapy is not easy to revive. There is a lack of modern studies that prove their effectiveness unbreakable. And authorities are reluctant to allow viruses as drugs.

Researchers from the Queen Astrid Military Hospital in Brussels have further developed phage therapy and have found a special solution for approval with the authorities. Patients so selected – especially severe cases such as Wael – can now be treated with phages.

A few more gaps in knowledge

It doesn't always work. This has to do with the fact that phages are extremely picky: they need the right phages for each bacterium to treat. Currently, researchers from Brussels have phages for three types of bacteria.

"We need to find out even better in which cases phages work and in which cases they don't," says Jean-Paul Pirnay of Queen Astrid Hospital. Given the crisis of antibiotic resistance, he declares himself despite his lack of knowledge of phage use: "If a patient dies, don't you have to help him?"

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