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Phages are not the silver bullet that people think they are. First they're difficult to make and store (antibiotics are mostly shelf stable... phages aren't).

Phages are not the silver bullet that people think they are. First they're difficult to make and store (antibiotics are mostly shelf stable... phages aren't). Second, they are not broad spectrum. Third, (at least in the US) phage therapy hasn't taken off because the initial forays into phages showed that they can cause reactions. Lastly, not all bacteria have phage counterparts. So if you even could use phages, you're looking at weeks of testing to determine what bacteria to target, before production. You could keep a library of phages for known bacteria, but that library would be highly specific.

bratwurst3000 4y ago
Isnt it that phages can be engeneered to a specific bacteria? Also the other way around. The can be programmed with the dna of the bacteria. So pcr the bacteria then make phages that atack them. My knowledge is bad . Could you elaborate where the engeneering problem is and the cost factors? Thanks
- John23832 4y ago
  The problem is that they are highly specific. You would need the industrial machinery to manufacture a highly specific treatment. With anything in medicine/biology, specificity dramatically increases cost. There's also the pre-treatment testing that would be necessary to determine what to target. There's also the shipment of a bacterial specimen that would be used to create a phage (which is something we don't do currently... we'll ship a specimen to a testing center, best case). Those are two different bacterial specimens needed. Then you have to ship the phages back. Alive. Then store and administer then properly. People fail to take their antibiotics properly. They're going to royally screw up phages. What about bacteria that you can't culture (treponema pallidum, aka syphilis)? All of this is in contrast to antibiotics. Is it gram positive or gram negative? Treat. Did it work? Yes, good. No, treat again. Did it work? Yes, good. No, test for resistance. Move to a stronger antibiotic and repeat. You really don't even need to know what the exact bacteria is that you're targeting with antibiotics.
  - bratwurst3000 4y ago
    Thank you very much. I google a bit and here in germany we are allready building a database and a stock of phagea for specific bacteria. They allready have over 1000 phages. They also have „phage cocktails“ for broadband. They also state your points. Thanks again. Here the link in german https://www.dsmz.de/press/press-releases/singleview/zertifizierte-phagen-forschung-in-braunschweig https://www.dsmz.de/press/press-releases/singleview/zertifiz... And this video is rly interesting https://m.youtube.com/watch?v=YI3tsmFsrOg https://m.youtube.com/watch?v=YI3tsmFsrOg
- DonaldFisk 4y ago
  They're numerous and widespread, so it should be possible to find the phage you want. If bacteria evolve to develop resistance to it, bacteriophage can evolve to overcome that resistance.
DonaldFisk 4y ago
They're highly specific, and are harder to administer. They're usually stored in glass phials which need to be kept in a refrigerator. Stomach acid needs to be neutralized if they're taken orally. If administered by injection, the strain used can only be used once as the body develops antibodies to it. Most of the scientific literature on them is in either Georgian or (if you're lucky) Russian. They're not without their problems, but there are also problems with antibiotics (bacterial resistance, penicillin allergy). So why not use them whenever use of antibiotics is problematic? They're cheap, and reproduce at a phenomenal rate. They were used successfully in the Soviet Union, and are still being used in Georgia.
- John23832 4y ago
  I'm not saying that they can't be used. They can. People often take new(ish) tech as a cure-all. There are still challenges though. For bacteria with high resistance (which is what we have the biggest issue with), we've typically done a workup of the bacterium to target. In the worst case, these are what land people in the hospital. Hospital settings would be the best administration point for these therapies. The problem would still be the creation of the specific phages in a reasonable fashion. This would only really be available at major hospitals in major cities. And so... limited in usage. I could see major hospitals keeping a large amount of gonococcal phages on hand though. Edit:: One more thing. As far as antibiotic allergies (you mentioned beta lactams) we typically have antibiotic alternatives. Doxycycline is pretty much well tolerated by everyone. And it's available in pill form.
sudosysgen 4y ago
Viruses are generally extremely well preserved as long as you deep freeze them.

bratwurst3000 4y ago

Isnt it that phages can be engeneered to a specific bacteria? Also the other way around. The can be programmed with the dna of the bacteria. So pcr the bacteria then make phages that atack them. My knowledge is bad . Could you elaborate where the engeneering problem is and the cost factors? Thanks

John23832 4y ago
The problem is that they are highly specific. You would need the industrial machinery to manufacture a highly specific treatment. With anything in medicine/biology, specificity dramatically increases cost. There's also the pre-treatment testing that would be necessary to determine what to target. There's also the shipment of a bacterial specimen that would be used to create a phage (which is something we don't do currently... we'll ship a specimen to a testing center, best case). Those are two different bacterial specimens needed. Then you have to ship the phages back. Alive. Then store and administer then properly. People fail to take their antibiotics properly. They're going to royally screw up phages. What about bacteria that you can't culture (treponema pallidum, aka syphilis)? All of this is in contrast to antibiotics. Is it gram positive or gram negative? Treat. Did it work? Yes, good. No, treat again. Did it work? Yes, good. No, test for resistance. Move to a stronger antibiotic and repeat. You really don't even need to know what the exact bacteria is that you're targeting with antibiotics.
- bratwurst3000 4y ago
  Thank you very much. I google a bit and here in germany we are allready building a database and a stock of phagea for specific bacteria. They allready have over 1000 phages. They also have „phage cocktails“ for broadband. They also state your points. Thanks again. Here the link in german https://www.dsmz.de/press/press-releases/singleview/zertifizierte-phagen-forschung-in-braunschweig https://www.dsmz.de/press/press-releases/singleview/zertifiz... And this video is rly interesting https://m.youtube.com/watch?v=YI3tsmFsrOg https://m.youtube.com/watch?v=YI3tsmFsrOg
DonaldFisk 4y ago
They're numerous and widespread, so it should be possible to find the phage you want. If bacteria evolve to develop resistance to it, bacteriophage can evolve to overcome that resistance.

DonaldFisk 4y ago

They're highly specific, and are harder to administer. They're usually stored in glass phials which need to be kept in a refrigerator. Stomach acid needs to be neutralized if they're taken orally. If administered by injection, the strain used can only be used once as the body develops antibodies to it. Most of the scientific literature on them is in either Georgian or (if you're lucky) Russian. They're not without their problems, but there are also problems with antibiotics (bacterial resistance, penicillin allergy). So why not use them whenever use of antibiotics is problematic? They're cheap, and reproduce at a phenomenal rate. They were used successfully in the Soviet Union, and are still being used in Georgia.

John23832 4y ago
I'm not saying that they can't be used. They can. People often take new(ish) tech as a cure-all. There are still challenges though. For bacteria with high resistance (which is what we have the biggest issue with), we've typically done a workup of the bacterium to target. In the worst case, these are what land people in the hospital. Hospital settings would be the best administration point for these therapies. The problem would still be the creation of the specific phages in a reasonable fashion. This would only really be available at major hospitals in major cities. And so... limited in usage. I could see major hospitals keeping a large amount of gonococcal phages on hand though. Edit:: One more thing. As far as antibiotic allergies (you mentioned beta lactams) we typically have antibiotic alternatives. Doxycycline is pretty much well tolerated by everyone. And it's available in pill form.

sudosysgen 4y ago

Viruses are generally extremely well preserved as long as you deep freeze them.