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Phage Therapy: A Novel Approach to Combat Bacteria



Phage therapy, also known as bacteriophage therapy, uses viruses to treat bacterial infections. The word bacteriophage means “bacteria eater,” and that’s exactly what these good viruses do. They attack only the bad bacteria and are harmless to humans, animals and plants.

Although phage therapy sounds innovative and new, it has actually been used for more than 100 years and has proven particularly effective as an alternative to antibiotics.

To learn more, Miami Living visited the Eliava Phage Therapy Center (EPTC), a pioneer in phage research and treatment. Founded in 1923 by Georgian physician and researcher Prof. Giorgi Eliava, the institute is based in Tbilisi, Georgia, and is a leader in phage research and therapy. It offers a range of consultations. It offers patients treatments and strategies for bacteriophage treatments for a range of complex medical conditions.


Markin Abras spoke with Mariam Dadiani, Assistant Physician at the Eliava Phage Institute, to gain unique insight into phage therapy.

Markin Abras: Where do phages originally come from?

Mariam Dadiani: Phages are naturally produced viruses that are found everywhere in nature and in the human body, they are simply designed to attack certain strains of bacteria.

MA: As far as I know, Eliava Phage Therapy Center’s main customers are from Europe, but what about the U.S. market? How has it changed over time?

MD: We have always had patients from the United States, but the European clients outnumber the Americans because the main problem is distance. Americans have to take a long flight and stay here for 2 weeks.

MA: What are the main reasons patients come to Eliava Phage Therapy Center?

MD: Antibiotic-resistant infections continue to be the main cause of referrals, where antibiotic therapy has proven unsuccessful and often impossible. In addition, patients with intolerances and/or allergies to antibiotics also come for treatment with bacteriophages.

We have also encountered a number of cases in which, despite susceptibility to antibiotics, antibacterial treatment has been ineffective, presumably due to the possible presence of a biofilm layer characteristic of chronic infections that is known to be difficult for antibiotics to penetrate.

The most common diagnoses we deal with are urinary tract infections, lung infections, intestinal dysbiosis, chronic non-healing wounds, etc.

MA: In the United States, there is very little information and virtually no licensed medical facilities offering phage therapy and services. Why is that?

MD: Because phages are not FDA-approved and there are no international guidelines/protocols, the U.S. has always been skeptical because they view the treatment as “non-traditional medicine.” Funnily enough, phages were first discovered and widely used before antibiotics - even in the United States.

Recently, phage therapy has become more important worldwide as antibiotic resistance becomes a major burden on the healthcare system. Eliava Phage Institute provides a treatment to combat multidrug-resistant superbugs, which pose a serious threat and have a high mortality rate.

MA: Is it true that some types of phage do not work as well in treating bacterial infections?

MD: That depends entirely on the type of phage used. Our phages are sterile filtrates of phage lysates. We have not often seen a strong immune response to phages. Our treatment plan consists of pauses where antibody levels drop.

MA: Some phages can cause bacteria to become resistant. What would you tell patients who are concerned about this?

MD: The risk of phage resistance is not as great as that of antibiotic resistance, to which there are no longer any alternatives. Our phage collection at the Eliava Institute includes thousands of phages, and we can prepare a customized, individual phage treatment from scratch, tailored exclusively to the patient’s specific strain of bacteria.



More on Phage Therapy


How Does it Work?

Bacteriophages attach to bacterial cells and inject their genome into the cell, which over time replaces the bacterial genome. This process stops the bacterial infection because the bacterial cells causing the infection can no longer replicate. Because phages are very precise and selective, they are very effective in treating certain strains of bacteria.

Phages are currently used therapeutically to treat bacterial infections that do not respond to conventional antibiotics.

Evaluation and Treatment

Patients visiting the Eliava Institute should expect to stay two weeks for appropriate testing, analysis of results and treatment. First, a comprehensive assessment of the patient’s needs, medical history and other factors is performed. Tests are also performed to further determine the patient’s needs.

Once the diagnosis is made, phage therapy begins. Phages are taken orally, usually twice daily on an empty stomach or two hours after eating. The phages come in small glass vials and taste a bit like mushrooms. Since phages are live viruses, they should be stored in the refrigerator to ensure their effectiveness.

Generally, treatment is given in 3 phases, each lasting about 20 days, with a 2-week break. The treatment has no side effects, as phages kill a bacterium only when it matches the specific strain.

The phages provided to the patient are from Eliava BioPreparations LTD, the pharmaceutical company that manufactures bacteriophages and produces and develops the phage therapies.


Availability

Phage therapy is not yet approved for patients in the United States and Europe because antibiotics are less expensive, patented and profitable, and readily available. Phage therapy, on the other hand, requires individual assessment and treatment. It is currently available in Georgia, Poland and Russia. However, the U.S. Food and Drug Administration (FDA) has approved the first clinical trial for intravenous phage therapy in the U.S. in 2019, and in 2020, the FDA will approve the first clinical trial for nebulized phage therapy.

Cost

The cost of phage therapy is approximately $4,000 to $5,000, which includes examinations, testing, diagnosis, treatment, and follow-up consultations.

Conclusion

As antibiotic-resistant infections become more common, phage therapy offers an effective treatment for bacterial infections that has no reported side effects. It is uncommon in the West, but is commonly used in Georgia as part of medical care, especially in paediatrics, surgical procedures, intestinal issues, and infectious conditions.

Contact

New patients should contact EPTC by emailing the center at https://eptc.ge/contact with a brief explanation of their condition. They can expect a response within a few days, and most medical staff members speak English.

Eliava Phage therapy Center

Address: 3 Levan Gotua St, Tbilisi 0160

Home page: https://eptc.ge

Phone: +995 32 272 86 86


By Markin Abras | Images courtesy of EPTC

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