Could Age-Old Therapeutic Treatments Be The Answer To Antibiotic Resistance?

04/08/2016

The number of deaths due to antibiotic-resistant infections is in the hundreds of thousands and quickly rising. It’s the end of the golden age of antibiotics, and the desperate search for more effective treatments has begun.

Ever since antibiotics were first discovered, disease-causing microbes have been evolving and finding ways to survive against their attacks.

Their use has increased tremendously over the last century and today statistics from the federal Centers for Disease Control and Prevention in the US show, that more than 2 million people each year are infected with a bacterium that displays resistant behaviour to at least one antibiotic medication designed to kill it.

Their figures also show at least 23,000 people who are infected by antibiotic-resistant infections die as a direct result of their effects, with an unknown amount of fatalities due to other conditions which have been complicated by the infection.

Worryingly, stated in a recent report released by the World Health Organization (WHO), scientists expect these figures to rise much higher. In their words, we’re entering a “postantibiotic era” — a step back into history when common infections and minor injuries could be fatal.

The way in which antibiotics have been quickly handed out by doctors to stamp out infections, often as a first line of treatment, is partly to blame. It’s also believed that using antibiotics in live-stock farming has contributed to widespread resistance.

The steady rise of disease-causing bacteria has meant traditional measures are no longer working. In response, doctors are forced to delve even deeper into the basement to bring back obsolete antibiotic medications. It seems this will continue until all the options are depleted, and the infection, or ‘superbug’, takes hold.

Drug-resistant gonorrhoea has already been identified and it’s even claimed by the WHO that it’ll soon be untreatable. Their reports also show extensively-drug-resistant tuberculosis to be circulating in at least 100 countries. And we’ve all seen the stories of methicillin-resistant Staphylococcus aureus (MRSA) rampaging through hospitals and taking the lives of many patients.

The effect of the superbug crisis is not as immediate as the likes of Ebola and the Zika virus, and thus, it scarcely enters mainstream media. The reality of antibiotic-resistance only really crashes home when it affects someone you know, such as a member of your family, or yourself.

Finding A Cure For Antibiotic-resistant MRSA

“We’re seeing more drug-resistant infections. And people will die.”— William P. Hanage, Harvard University infectious disease epidemiologist

At the ripe age of 51, Laura Roberts was informed she had just three months to live. The culprit: An MRSA infection that antibiotics were failing to cure.

Over the 7 years prior, the infections had spread from her sinuses to her ears, lungs, and stomach, affecting circulation to her limbs and causing her to suffer from constant nausea and pain. Doctors stormed through antibiotic medications to try and treat the incredibly resilient infection, but in the end, Roberts was told there was nothing more they could do.

“When I was told to get my affairs in order, it hit me like a ton of bricks” — Laura Roberts

Researchers haven’t discovered a new class of antibiotic medication since the 1980s. Although several new studies are being funded by National Institue of Allergy and Infectious Diseases (NIAID), to improve the process of diagnosing infections and therefore reduce the use of antibiotics by doctors and physicians, other scientists are attempting to combat resistance by genetically modifying antibiotics, so that the bacterial enzymes which cause resistance cannot attack them.

However, some scientists and researchers believe continuing down this path of antibiotic use may not be the answer to the problem.

One alternative treatment used instead of antibiotics, can be found in Eastern medicine, where it’s been used for centuries to outsmart resistant bacteria, namely ‘bacteriophage therapy’.

It was on hearing about bacteriophage therapy that Roberts gained back some hope for a cure. She made the arrangements and flew over to Tbilisi in Georgia, where ‘phage’ therapy, as it’s commonly known, is standard practice and drug resistance bacteria pose little problems.

Found in soil, water, and the digestive tract, phages are viruses that live off eating bacteria. They distinguish between good and bad cells in the body, killing bacterial infections while leaving good bacteria fully intact. Something that cannot be said for antibiotics.

“We badly need new antimicrobial treatments, but there aren’t that many coming down the pipeline… Bacteriophages are a largely untapped resource for that.” —Timothy Lu, associate professor of biological engineering at MIT

While in Tbilisi, Roberts received various courses of treatment which targeted the sources of infection. This involved regularly drinking bottles of a phage preparation and having instruments wrapped in phage-soaked gauze inserted into her sinuses. The treatment was pain-free, and within just 3 weeks, she was completely cured of the infection.

A New Era of Medicine and Therapeutic Treatments

Although discarded in Western medicine back in the 1930s, bacteria-killing viruses are making a comeback and some forecast that they will become widely used in the next 5 to 10 years. As antibiotic resistance increases, finding suitable alternatives to treat people is becoming increasingly important.

Whilst ‘phage therapy’ is currently one of the most promising solutions we have, a big barrier to their introduction to the mainstream is in gaining approval by drug administration authorities. In order for phage therapy be available in our hospitals it needs to pass rigorous testing and trials that meet standards set by organizations such as the FDA.

“We need to educate folks that this situation is going to change medicine, so that people will start asking the FDA to develop regulations that are not nearly as stringent. I don’t want it to reach the point of Ebola, where we have nothing to treat people on a large scale.” —Jason Newland, MD and member of Infectious Diseases Society of America’s antimicrobial resistance committee.

Cliff Synder, a microbiologist for the US Army Medical Research and Materiel Command, working with Walter Reed Army Institue of Research and AmpliPhi Biosciences, is on the quest to advance phage therapy through clinical trials and into the hands of patients who need it.

Much like how unregulated treatments were deployed to help in the fight against Ebola, treatments like phage therapy do have the chance of being delivered through medical pathways sooner. As with the case of Roberts, patients suffering from life-threatening infections could soon receive injections of a phage cocktail that may just save their life.

It was over ten years ago that Roberts was given just three months to live. She’s now 61, free from any trace of MRSA, and able to fully enjoy her life again. Her story and the many others that are sure to emerge are a testament to the new era of therapeutic and personalised medicine. Biological therapies such as phage therapy, stem cell therapy, and regenerative therapy are all demonstrating their effectiveness, showing that this is the direction in which our healthcare systems will inevitably lead.

Personalised treatments are uniquely tailored for each patient, rather than responding to a group of common symptoms. They target the source of the problem and leave healthy cells unharmed. Many of them are in limited use today, and thanks to success stories like Roberts, may soon be a reality for all.

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