We're losing the war against drug-resistant infections faster than we thought

> In the end you should end up with some phage solution which specifically attacks the bacteria

This reminds of the universal cure to disease being a bullet [1].

Phages are promising. That doesn’t mean they can’t hurt you [2].

[1] https://xkcd.com/1217/

[2] https://pmc.ncbi.nlm.nih.gov/articles/PMC8310247/

"we found some adverse events associated with phage therapy, but serious events were extremely rare."

The biggest hindrance is that the western process of developing and releasing new medicine is ill-suited for phage treatment.

> the western process of developing and releasing new medicine is ill-suited for phage treatment

…as evidenced by the booming phage industry somewhere in the east?

(The weird thing is this railing against western medicine or whatnot is usually a dead ringer for pseudoscience. Yet phages are a scientifically valid thereaupeutic route [1].)

[1] https://www.nature.com/subjects/bacteriophages

I don't understand your point? The only thing I said that the process of developing new medicine is ill-suited for phage treatment. This due the fact bacteria and phages are coevolving, hence any phage treatment is highly specific and hence not worth of developing. It needs new ideas to standardize the process and to make this process a legal treatment option.

> due the fact bacteria and phages are coevolving, hence any phage treatment is highly specific and hence not worth of developing

How is this different from antibiotics?

Nothing about phages makes them not worth developing. Exhibit A: they’re being researched and developed.

They are only active against a narrow strain of bacteria unlike antibiotics.

> are only active against a narrow strain of bacteria unlike antibiotics

And this makes them “not worth…developing” why?

(The comparison to antibiotics was that the antibiotic-bacteria system is coevolving too. Exhibit A: TFA on antibiotic resistance.)

Much slower, we are still using 100 year old antibiotics. Money one phage is going to make is much smaller. This is not cost effective to go through the whole process.

> Money one phage is going to make is much smaller

Again, what are you basing this on?

> This is not cost effective to go through the whole process

Now do personalized medicine.

Phages are binding to very specific proteins, where as antibiotics disrupt more fundamental processes.

Personal medicine as in individual combination of existing drugs is easier to achieve in current regulatory framework then using new drugs.

That's only partly it.

The whole procedure of selecting a phage personalized for the patient and then growing it into a treatment is so slow the patient may die before it's ready. Works for chonic infections but not much else.

There are probably phage treatments that are not personalized: test susceptibility and then mail-order the treatment. That treatment:

  - Would be very expensive to *produce* compared to most antibiotics. I emphasize *produce* because the price of antibiotics rarely reflect how much it costs to produce them. Compared to antibiotics, phage treatments have very low margins.

  - Would work for a very limited percentage of patients (probably less than 10%). There are hundreds of phages for each bacteria species (yes, they're species-specific and sub-species-specific). 

  - Have a very *very* short shelf life, possibly a couple of days. So, no pharmacy or hospital can keep a sufficiently diverse supply of phages in store to treat most patients, possibly not even whole countries.

BTW, species specificity and shelf life applies to the susceptibility test kits too.

1) Phages are specific for each bacteria species or sub-species. Can't treat E.coli and Klebsiella with the same phages like we do with antibiotics. Not even the test kits are the same. There are hundreds of phages for each bacteria species and only a few of them would work for each patient.

2) Phages are live organisms (as much as you can call a virus "alive"). The shelf life is very very short. A couple of days probably.

1 + 2 => A hospital would have to store thousands of different phages to be able to treat most of it's patients and it would have to replace those stores twice a week.

> hospital would have to store thousands of different phages to be able to treat most of it's patients and it would have to replace those stores twice a week

Couldn’t you create a few compound batches that treat sets of bacteria, balancing distribution cost and side effects?

Do that a little, remove phages that don’t work better than antibiotics, tailor for local conditions and I doubt you’re adding more than a few dozen medicines to the hospital’s inventory.

> shelf life is very very short. A couple of days probably

Plenty can survive cryogenic suspension [1].

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC3131515/