![]() ![]() A phage that does not amplify fast enough or cannot access its host in some tissues may fail clinically, even if it works well in the lab. Yet successful treatment with phages is necessarily founded on dynamic principles just as pharmacodynamic properties determine whether a drug that kills a bacterium in vitro will actually be effective in vivo ( Bull and Regoes, 2006 Levin and Bull, 1996, 2004 Payne and Jansen, 2001, 2003). In concept, phage therapy seems invincible: a self-replicating organism selectively killing only a pathogen, amplifying itself only where it is most needed – sites where the pathogen is lurking and abundant. Yet after more than a decade of promulgation in the U.S., it has been approved only for treatment of processed food and plants and has seen little interest from Big Pharma ( Brussow, 2005 Carlton et al., 2005 Coates and Hu, 2007 Hanlon, 2007 Leverentz et al., 2003 Mattey and Spencer, 2008 Projan, 2004 Schoolnik et al., 2004 Soothill et al., 2004 Sulakvelidze, 2005). Only now, amid an ever-growing threat from antibiotic resistant bacterial pathogens, is it being entertained again in the West. Proposed and practiced before the development of antibiotics and before phage genetics was even understood, phage therapy was disgraced and displaced in the West by antibiotics during the 1940s, although it survives even today in Eastern Europe. ![]() The use of phages to treat bacterial infections, phage therapy, is an enigma of Western medicine. ![]()
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