![]() ![]() Several studies regarding BP use in vitro, in experimental animals and in humans have been performed in both the United States and Europe. The difficulties in the treatment of many life-threatening bacterial infections have led scientists to reconsider BPs. The situation has radically changed in the last 30 years, especially in the last decade, as a result of the rapid rise of multi-drug-resistant bacteria worldwide coupled with a decline in the development and production of novel antibacterial agents ( Perros, 2015 World Health Organization, 2018). However, mainly because most antibiotics were not available, BPs continued to be used in Russia and in Eastern Europe, particularly in those countries previously included in the Soviet Union ( Abedon et al., 2011). The increasing availability of safe and effective antimicrobial drugs after the Second World War has further contributed to the low esteem in which BPs were held in the West until the 1980s ( Chanishvili, 2016). Moreover, when some results were translated and diffused among English-speaking scientists, they were seen with skepticism, as most of the clinical trials did not follow the international standards ( Chanishvili, 2001). However, most of these publications were written in Russian and did not reach the Western world. The results were considered very satisfactory and were published in several reports ( d’Herelle, 1931 Summers, 2001). Due to his collaboration with his Georgian colleagues, BP therapy was largely used in the Soviet Union in patients of any age suffering from a wide range of diseases. Administration of BPs for this purpose dates to about a century ago, mainly based on the studies of a French researcher, Felix d’Herelle. For this reason, it is supposed that they can be used, alone or in combination with antibiotics, to treat bacterial infections ( Domingo-Calap and Delgado-Martínez, 2018). Further studies specifically devoted to solve these problems are needed before BPs can be used in humans.īacteriophages (BPs) are viruses that can infect and kill bacteria without any negative effect on human or animal cells. To date, the problem of how to prepare the formulations for clinical use and how to avoid or limit the risk of emergence of bacterial resistance through the transmission of genetic material are not completely solved problems. However, present knowledge seems insufficient to allow the use of BPs for this purpose. ![]() Use of BPs to overcome the problem of increasing bacterial resistance to antibiotics is attractive, and some research data seem to indicate that it might be a rational measure. Literature review showed that the rapid rise of multi-drug-resistant bacteria worldwide coupled with a decline in the development and production of novel antibacterial agents have led scientists to consider BPs for treatment of bacterial infection. PubMed was used to search for all of the studies published from January 2008 to December 2018 using the key words: “BPs” or “phages” and “bacterial infection” or “antibiotic” or “infectious diseases.” More than 100 articles were found, but only those published in English or providing evidence-based data were included in the evaluation. In this narrative review, the advantages and limitations of BPs for use in humans will be discussed. For this reason, it is supposed that they can be used, alone or in combination with antibiotics, to treat bacterial infections. 2Department of Surgical and Biomedical Sciences, Pediatric Clinic, Università degli Studi di Perugia, Perugia, Italyīacteriophages (BPs) are viruses that can infect and kill bacteria without any negative effect on human or animal cells.1Professor Emeritus of Pediatrics, Università degli Studi di Milano, Milan, Italy.Nicola Principi 1, Ettore Silvestri 2 and Susanna Esposito 2* ![]()
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