There was a young man, Bob, in 1949, a WWII bomber pilot who was getting on with his life after the war. One day, he woke up to do his morning ritual of coughing up phlegm (he was a 2-pack-a-day smoker), and in the process, he coughed up a piece of bloody lung. His wife, Gloria, who had watched her husband’s health deteriorate over the past few months, insisted that he go to the doctor. The doctor immediately diagnosed him with tuberculosis and checked him into the local sanatorium. Gloria was sick with worry about her husband’s chances. Gloria’s mother, Hazel, in hopes of calming her fears, called the doctor in charge of the sanatorium.
“So how is my son-in-law doing?” she asked.
“Well, he has a fever and has lost a lot of weight, but we have him checked into room 212, and he is resting comfortably,” the doctor replied.
“How do you think he will do?”
“Ma’am, I would not give a plug nickel for his life. I don’t think he will make it past the week.”
Hazel turned to her daughter and said, “He’ll be fine.”
What the doctor didn’t realize was that the new drug, Streptomycin, was available for treatment. Bob was given streptomycin, and it reversed the course of the disease and saved his life. It still took a full year for him to recover, due to the extensive damage Mycobacterium tuberculosis had done to his lungs, but he made it. Robert Paustian was my father, and I am only here today because that drug saved his life. Antibiotics really are miracle drugs.
As soon as widespread use of antibiotics began in the 1940s, antibiotic-resistant bacterial pathogens began to appear. Antimicrobial resistance (AMR) has been a growing problem ever since. In 2021, there were an estimated 4.71 million deaths attributable to AMR, and untreatable infections are becoming too common. There is a need for effective methods to combat this growing trend. In 2017, the World Health Organization put out a call for new antibiotics to counter these AMR strains. The research community has responded with the development of sixteen new drugs. These drugs fall into known categories with understoond modes of action, but they are capable of treating drug-resistant strains.
A different approach is the use of viruses of bacteria (called bacteriophage) that can specifically target and kill these pathogens. Phage therapy has been gaining momentum over the past few decades as more untreatable infections have arisen. These phages are found by using sources where these troublesome bacteria hang out (wastewater, natural water sources, and the human body) and then mining them for viruses that will attack pathogens. The equipment needed to go phage-hunting is simple: a suitable medium that the pathogen can grow on, a method to sample the environment, and a dilution buffer. The researcher then simply cultures the bacterium in the presence of the natural sample and looks for lysis of the culture. With enough trials, bacteriophage are bound to be found that kill the target bacterium.
These phage can then be stored and deployed to treat AMR infections. The regulatory framework is yet to catch up with phage therapy, so it is normally used in cases where antibiotics fail, and there are no other options. Approvals are often on a case-by-case basis. This area of treatment needs to be standardized and gain approval from government organizations so that it can become a common method of treating AMR infections.