The results are said to be impressive ..

http://www.worldcrunch.com/tech-science/if-antibiotics-don-039-t-cut-it-ancient-phagotherapy-makes-a-comeback/phages-antibiotic-resistant-infections-phagotherapy-georgia/c4s14670/#.Ux-BlO-9KK0

Phages are currently being used to treat bacterial infections that do not respond to conventional antibiotics (Russia Georgia).

Adv: Beneficial bacteria saved

Dis adv: Strain specific (strain variant pathogen will not be killed).

To Tobias,

What do you mean "a disadvantage was that resistance arises extremely quickly"? Do you mean phage might help spread resistant genes from one bacteria to other close-related bacteria through transduction while not kill the recipient bacteria?

Maybe we should keep an open mind on this issue. (I have no vested interest in any commercial enterprise using phage technology).

Using bacteriophage as a treatment is again interesting. Perhaps it works because it doesn't completely eliminate the pathogen and at the same time doesn't touch the rest of the microbial flora!

The problem with antibiotic treatment is that it destroys the bacterial flora indiscriminately leaving the host open for devastating infections by any multi resistant opportunistic saprophyte/commensal that happens to be around. Phage however decimate the original targeted pathogen but this will establish resistance to the phage rather rapidly (loss of surface receptors, CRISPR/cas mechanisms, uptake of restriction/modification systems, lysogenisation etc). This means that the virus resistant pathogens will still be around and proliferating after a few days. In the case of changes in surface proteins for acquired resistance this may change (reduce) the virulence of the phage-resistant pathogen or make it more visible to the host immune system. In any case the virus treatment will dramatically initially reduce the pathogen concentration and may allow sufficient time for the host to recover and develop better immune defence.

At the same time, and this is in contrast to antibiotics, the natural flora is still present to compete for binding sites on gut epithelium etc., give support to the host, aiding digestion, uptake and production of vitamins etc.. It was established already in 1979/80 that the cessation of antibiotic treatment removed the selective advantage of the opportunistic infection (often lethal; patients dying from multi resistant plant saprophytes with often promiscuous transfer of antibiotic resistance;e.g. Erwinia ananas Starr 1979) allowing recovery by reestablishment of the normal flora. These findings lead to reduction in wide-spread preventive antibiotic treatment of ambient patients in hospitals and putting flowers and fruit in patients rooms.

Having worked myself a long time with bacterial viruses and seen how rapidly resistance develops I was surprised to see positive results with clinical trials. On the other hand it was known that if you wanted to work with bacterial genetics in a lab that had once been contaminated with T-even (T1, T7) viruses the only way was to use strains that were known to be resistant. They stayed around for decades and caused lytic killing of liquid cultures within an hour.

Although bacteria can develop resistance to phage, the resistance might be easier to overcome than resistance to antibiotics. Just as bacteria can evolve resistance, viruses can evolve to overcome resistance.

Lysogenic bacteriophages are not generally used therapeutically, as this group can act as a way for bacteria to exchange DNA; this can help spread antibiotic resistance or even, theoretically, make the bacteria pathogenic

Bacterial mechanisms of phage resistance include adsorption resistance (restriction), which results in reduced interaction between phage and bacterium, where bacteria live but phages die; and abortive infections, where both phage and bacterium die. Adsorption resistance includes loss of phage receptor molecules on hosts as well as physical barriers hiding receptor molecules (e.g., capsules). Restriction mechanisms egs., are phage-genome uptake blocks, superinfection immunity, and restriction modification.

It could be just the opposite to what you are thinking. Phages may produce more resistant cells.

Is there any concern about the mutation of phage that might infect good bacteria or even human cells?

Replying to Daniels vague concerns about 'mutation' killing the good guys (haunted by the post-atom bomb films of giant spiders and ants?). I really recommend looking at Stan Falkow's overview on pathogenic micro-organisms and host defence ( http://www.youtube.com/watch?v=0RZkgWnLXuI ). The basic first line of inherent resistance is the normal flora occupying the niche (respiratory and gut mucosa) and preventing opportunistic override. Most pathogens are present all the time (e.g. in gut or mucosal flora) in low numbers and don't cause disease. Maybe they are good guys too?! I've never heard of a bacterial virus infecting a human cell. Am I just ill-informed? For such a pathogen virus to evolve/ develop just how many mechanisms would it need to acquire and optimise to cross barriers, perpetuate, scavenge, adhere, penetrate, avoid macrophage, avoid inducing 2nd level innate response and avoid inducing adaptive immune response....etc? So unlikely that it is not worth considering.

Didier Fesquet wrote " the results are said to be impressive and gives a link: the link is a newspaper article and an anecdotal account of an illegal treatment and upcoming trials on infected burns patients. I didn't find anything to support the statement that phage are effective. All the same it may well be wise to consider alternatives to antibiotics in areas where nosocomial infection is likely to be widely resistant to antibiotics.

Sir all these replies are quit e interesting , but i have small doubt , when i plate the bacteriophages in spot test for first two days complete clearance can be seen but after a week the lawn merges in the spoted area, how can one justify that bacteriophages will be a suitable alternative , because the bacteria gains resistance against the phages and it grows