Pros and cons of phage therapy

TLDR

Phage therapy employs bacteriophages to target bacteria, offering self‑amplification, minimal flora disruption, efficacy against resistant strains, and low toxicity, while reported disadvantages are generally minor. This commentary aims to consolidate and evaluate the advantages and disadvantages of phage therapy, including safety, economic, and convenience considerations. The authors discuss how autonomous phage transfer between animals could reduce application frequency and improve convenience, though it is not essential to therapeutic success.

Abstract

Many publications list advantages and disadvantages associated with phage therapy, which is the use of bacterial viruses to combat populations of nuisance or pathogenic bacteria. The goal of this commentary is to discuss many of those issues in a single location. In terms of "Pros," for example, phages can be bactericidal, can increase in number over the course of treatment, tend to only minimally disrupt normal flora, are equally effective against antibiotic-sensitive and antibiotic-resistant bacteria, often are easily discovered, seem to be capable of disrupting bacterial biofilms, and can have low inherent toxicities. In addition to these assets, we consider aspects of phage therapy that can contribute to its safety, economics, or convenience, but in ways that are perhaps less essential to the phage potential to combat bacteria. For example, autonomous phage transfer between animals during veterinary application could provide convenience or economic advantages by decreasing the need for repeated phage application, but is not necessarily crucial to therapeutic success. We also consider possible disadvantages to phage use as antibacterial agents. These "Cons," however, tend to be relatively minor.