Chapter 19 : Bacteriophage Clinical Use as Antibacterial “Drugs”: Utility and Precedent

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Phage therapy is the use of bacterial viruses to reduce or eliminate bacterial infections. As such, phage therapy has been employed clinically for approximately 100 years. It is possible, nevertheless, that more English-language reviews and commentaries on bacteriophage use as antibacterial agents are published yearly (e.g., for 2015 [ ] and for approximately the first third of 2016 [ ]), than there are people within the borders of the United States who are subject to officially sanctioned phage treatment. This contrasts with well over 100 million courses of antibiotic that are prescribed per year ( ).

Citation: Abedon S. 2018. Bacteriophage Clinical Use as Antibacterial “Drugs”: Utility and Precedent, p 419-451. In Britton R, Cani P (ed), Bugs as Drugs. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.BAD-0003-2016
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Prevalence of use of the phrase “phage therapy” in the literature. Google Scholar searches were performed without “include patents” or “include citations” checked. Shown are searches on “phage therapy” (in quotation marks, ●), “antibiotic resistant” OR “antibiotic resistance” (as written, ○), “bacteriophage” (▼), and “microbiology” (△). To limit presentation of spurious results, the axis begins at four hits. Results and discussion: ●: “phage therapy” as a phrase is present to a small degree during the skepticism period (early 1930s through mid 1940s) and just prior to the recent revival (mid 1980s through mid to late 1990s) but then displays what appears to be renewed enthusiasm leading up to 2001. Starting from 2003 there then is a steady if less steep climb with a doubling approximately every 4 years. Relative lack of use especially prior to 1950 could reflect the popularity of alternative phrasing for “phage therapy,” including in non-English publications, though this possibility was not explored. ○: Reference to antibiotic resistance goes through an initial spurt beginning around 1950 and peaking in about 1960. This is followed by a nadir in 1963 and then a steady if less steep rise with a doubling approximately every 7 years. The presented curve first comes to exceed that of “bacteriophage” in 2005. ▼: Reference to the word “bacteriophage” likely is less representative early on due to non-English publications. Nevertheless, again there is early enthusiasm that is discernible starting around 1920 and peaking in the early 1930s. This is followed by a slow decline that levels out during 1943 through 1945, i.e., toward the end of World War II. A steady climb follows that parallels the rise in the use of the term “microbiology,” as indeed, so does the rise in reference to antibiotic resistance, but which to a degree plateaus for “bacteriophage” around 1990. Though not explored here, it can be speculated that the slower increase in use of “bacteriophage” starting in 1990 is a consequence of a greater prominence of the use of “phage” instead in publications, though alternatively, this switch may reflect a real decline in the rate of growth of the field; for additional data on the prevalence of bacteriophage publications, see reference . △: Reference to “microbiology” is presented as a general growth-in-the-literature control. The peak in 2007 and subsequent steady, ultimately multifold decline in its use is inexplicable, but similar drops are also seen with searches on “biology,” “chemistry,” “physics,” and “physiology” (not shown), so this likely reflects indexing lags by Google.

Citation: Abedon S. 2018. Bacteriophage Clinical Use as Antibacterial “Drugs”: Utility and Precedent, p 419-451. In Britton R, Cani P (ed), Bugs as Drugs. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.BAD-0003-2016
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