Although bacteriophage therapy–or “phages” for short–has been a successful alternative to antibiotics for over a century in Eastern Europe, you likely haven’t ever heard of it. Coming from the Greek word meaning “to devour,” phages do something similar: they are viruses that are sent purposefully into the human body to attack bacteria while leaving humans unharmed. The result is what many scientists believe to be a powerful alternative to antibiotics, which UTIs are rapidly developing immunity to. Yet if phage therapy is so effective and has a successful track record, why is it still so unheard of and scarcely used in the West? Finally, what is the outlook for phage therapy’s use in combating UTI, particularly chronic and treatment-resistant UTI?
Use of traditional antibiotics for UTI
60% of women will get a UTI in their lifetime. Moreover, 30% of women who experience a urinary tract infection will go on to develop another, often within just a few weeks or months of the initial infection. With the go-to treatment for UTI being antibiotics, it is not uncommon for those experiencing chronic UTI to develop antimicrobial resistance to antibiotic therapy. In the teachings of traditional (antibiotic) treatment for UTI, this could lead to a dead-end of therapeutic options. Because of the resistance to antibiotics, those living with UTIs might eventually run out of options for traditional treatment.
The basics of phage
That’s where phage therapy comes in. Although phages are far from a household name in the United States, research shows that phage therapy can be a potent alternative to standard antibiotic treatment for UTI. Originating in 1915, phages have been used effectively in treating bacterial infections for longer than you or I have been alive. The science around phages may seem complicated, but it is less daunting than it appears at first glance.
But what is a phage exactly? Bacteriophages are microscopic viruses that are found naturally in the environment. For every unique bacteria, there is a unique phage that can target it, making phages a powerful weapon against infections. These microorganisms can be taken orally for UTI. After being sent into the human body, phages find bacterial cells and pierce the cell body with their stingers, thus infecting the unwanted bacteria. The phages then go through a process where they multiply by exploding bad bacteria and proceeding to propagate further within the bloodstream. This process is known as “lysis.” While this may sound violent or painful, phages are well-known to have no aversive effects when used therapeutically.
Phage therapy benefits
There are many benefits of phage therapy in place of antibiotics for chronic UTI. As bacteriophages only infect their host bacteria, this results in less harm to the patient as a whole. Unlike antibiotics, phages do little harm to good bacteria or natural human "flora." In addition, research suggests that phages can be more effective than traditional antibiotics in treating UTI-related biofilms. Not only that, but phages participate in an effect called “auto-dosing,” where the phages themselves sense the strength of the bacterial infection and adjust their “dose” accordingly to be the most effective. Finally, and most importantly, phage therapy remains a viable option for those living with UTI instead of antibiotics, as antibiotics often lead to antimicrobial resistance and even the development of superbugs. Phages have low toxicity when compared to traditional antibiotics, and scientists have concluded that phage therapy has few cons.
Why is phage therapy so uncommon?
You may wonder why phage therapy is still underutilized if it can be so effective and is backed by science. Indeed, while phage therapy has been therapeutically used in parts of the world with success since 1919, it is still almost impossible to access in the Western world. There are multiple reasons why phage therapy didn’t take off in many parts of the world. For one, phages were discovered before the advent of antibiotics, and for a long time were poorly understood. Antibiotics, on the other hand, took the world by storm, creating a new standard for healthcare and life expectancy.
The initial success of antibiotics caused a lack of research into bacteriophage therapy for many years. However, the glaring issue of increasing antimicrobial resistance with antibiotics can lead to life-threatening sepsis from antibiotic-resistant infections. Yet although science strongly supports the therapeutic use of phages, its lack of early adoption by scientists in the West has resulted in the research far outpacing the actual usage of this life-saving therapy.
Phage therapy for UTI
Though phage therapy is not an accessible option yet for those living with UTI in many parts of the world, there is very encouraging evidence that it is a great alternative to traditional antibiotic treatment for people experiencing chronic or recurrent UTI. Unlike antibiotics, phage therapy can target specific antibiotic-resistant bacteria, multiplying and continuing to fight off infections in the process. For people living with UTI who haven’t found success with antibiotic treatment, this is a hopeful option for the future. Phage therapy for UTI can target specific biofilms that cause significant harm in recurring UTI. In addition, phages don’t damage microorganisms in the human body the same way antibiotics do. All of these listed reasons showcase the great untapped potential of the usage of phage therapy for treating chronic UTI. With emerging scientific research into the many benefits of phage therapy for the treatment of UTI, there remains hope that it will become a more accessible treatment for many in the future.
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