Getting Phage Therapy

There are several options to take advantage of phage therapy :

• Option 1: go to a country offering bacteriophage therapy and be treated by the local medical body

• Option 2: go to a country offering bacteriophagic treatment , buy a bacteriophagic cocktail and treat yourself

• Option 3: buy the phage treatment by mail-order and bring it back home outside the local medical system

• Option 4: get phage therapy in your own country thru the local medical body

The following is no medical advice or recommandation: please contact your physician. This is just a recension of general information from Wikipedia and other websites such as Pubmed, to discuss with your doctor :

Conservation

If a phage vial is cloudy, throw it away: is that it is no longer sterile. The conservation is done in the refrigerator to extend shelf life, but phages be stored for several months at room temperature.

phage adequacy / bacterium

Since d'Hérelle we know it is better to test the effectiveness of bacteriophage on the seed before using where possible. This is also recommended for most records.

When, thanks to an antibiogram, the type of bacteria is known , it allows to search for a cocktail of phages designed to be active on the bacteria, or specific to that bacterium.

Another approach for getting bacteriophage therapy is to select a cocktail adapted to the infectious type and location and not to the (unknown) germ, or even to any infection (Phagic composed of phages attacking the most common pathogens).

One of the difficulties reported in the literature on phage therapy is that it may be useful to adapt bacteriophage therapy en route if the bacterium mutates.

It indicates that these mutations often render the bacteria sensitive to antibiotics when there were previously become resistant as a result of repeated antibiotic treatments. Hence the advantage of combining phage therapy with antibiotics, even if the seed had become resistant to the antibiotic. The logic is not to begin phages after a few days of antibiotics: and the bacteria will be more susceptible to phage and there will be less so less risk of transformation to a phage resistance. Several publications have confirmed that synergy between phage and antibiotics.

Someone who would take a phage cocktail purchased in pharmacies and merely follow the dosage indicated in the instructions could only hope that the treatment works. As the cocktails contain several bacteriophages, he could hope that even if some bacteria mutated during treatment, some of the phages in the cocktail would be active on the mutant bacterium. The main risk of such a blind use seems that the cocktail might prove ineffective.

Side effects

Medical literature available on Internet (for example on Pubmed) does not mention serious side effects. Some studies frequently report a slight fever at the beginning of the treatment is generally understood as the reaction of the body to the sudden presence of bacterial waste or toxins in the organism from bacteria killed by bacteriophages. There are some reported cases where treatment had to be stopped because of a fever but are anecdotal.

Speed ​​of action

Phage acting quickly, most of the bacteria is usually quickly destroyed (a few hours, days or even a week in many cases reported). When the treatment is effective, Symptoms of infection immediately begin to decrease or disappear, but treatment is usually prolonged several days.

Conversely it is generally recognized in the literature that if the symptoms do not disappear in the first days of treatment, then treatment will usually not effective. D'Hérelle already mentions in his autobiography.

Types of treatment

The records searchable by internet advocate to test the efficacy of phage cocktail on the bacteria present on the site of infection before use. But some doctors also prescribe bacteriophages without test, either for reasons of emergency, or to make things simple.

On the contrary, when treatment occurs in a specialized center, it will first, before treatment, test bacteria resistance againts standard phagic cocktails and, if standard cocktails are ineffective, against bacteriophages that the center retains to this effect in its “phagothek”. If the standard cocktails are ineffective, once active phages have been identified in the "phagothek", these will be mixed in a cocktail specific to the infection and administered to the patient.

Moreover, every day or every other day, bacteria present on the site of the infection will be retested with bacteriophages of the "phagothek". Indeed bacteria can mutate and develop resistance against phages. It will then be necessary to find in the phagothek new more virulent phages against the bacteria that survive. This process increases the odds of a successful treatment.

Another approach is to naturally produce more aggressive phages by successively re-exposing the same original strain of bacteria to successive generations of relatively active phages. Generation after generation phages become more active and when efficiency is deemed sufficient, phages are administered to the patient. In this refining process, the various phage generations must be faced with the original bacterial strain. Phages and bacteria must not be allowed to evolve together over generations. If they did, bacteria would mutate too, they risk becoming rather more resistant to phages.

Acidity opponent phage

Almost all sources state that the phages are vulnerable to stomach acid, This poses difficulties for oral treatments. To avoid this acidity, different approaches are used: taking an antacid treatment (omeprazole) for days before swallowing the phage, Phage take fasting morning, take baking soda in a glass of water 10 20 minutes prior to treatment, etc…

The same problem arises with the urine in the treatment of urinary tract. In his Handbook of the twenty-first century Doctors Dr. Rich recommends 10 at 25 g of sodium bicarbonate per os during the 4 or 5 days preceding the treatment of urinary tract infections.

Examples of dosages

In one case notified by the Medical Microbiology Department of the Radboud University in the Netherlands, Dutch patient has been cured by following exactly as the Eliava Institute, which had provided bacteriophages correspondence. Although the patient had previously been treated unsuccessfully by meropenem seven times for periods of 10 days 4 weeks without symptoms disparussent, this time the symptoms disappeared after the first day of phage therapy + meropenem and germ had still not reappeared 14 months later.

Exactly as the Eliava Institute was: “taken orally twice a day of a vial (de 10ml) Bacteriophages and bladder instillation probe twice daily a vial, for two weeks. Then a bottle by mouth and another by bladder instillation every day for the next two weeks. And finally a bottle by mouth and by bladder instillation every other day for eight weeks.” Is 14 boxes of 4 bottles + 7 cans + 14 cans 12 weeks of treatment. Simultaneously, the patient was undergoing treatment 6 weeks of meropenem.

The Polish Institute of Hirszfeld overlook their website for information on treatment administration, which lasts from home 2 at 6-8 weeks:

“Our phage formulations are prepared in liquid form. They are applied orally, local and / or rectal. For oral application, you take a medication neutralizing the acid (until 20 minutes before oral administration of the formulation) or a gastric acid inhibitor to limit the destruction of phage by gastric acid. In local application, the formulation will be applied 1 at 2 once daily as a wet compress (wet dressing), seat bath, nasal or ear drops, aerosol, the gargles, of vaginal irrigation, of fistulae or abscess cavity. Rectally, 10 at 20 ml instillation of the formulation will be applied 1 at 2 times a day.”

In its notices, Russian laboratory Microgen also mentions taking rectal. To do this you have to buy a pharmacy pear. Your doctor can advise you.

The medical literature shows that even when applied directly to the site of infection, phage are also often simultaneously administered orally, and sometimes rectal. This amounts to a 100ml bottle per day, or box 4 vials of 20ml.

The Poles Therapy Center Phages by the Institute Hirszfeld find phage susceptibility rate of more than 80% for Staphylococcus aureus and Pseudomonas aeruginosa.

Finding Help

Dr. Paul Hervé Riche, a retired great defender phage therapy , may be able to help or advise your doctor. Its website provides extensive information, particularly in the Frequently Asked Questions. With another medical doctor, Dr. Garrigues, he published a book on treatments by bacteriophages: “Phage Therapy Practice Manual for XXIst century “.

Your doctor will also find information from the Pasteur Institute or the French medical literature, abundant on the subject but which dates from the time of phage therapy was widely used in France.

Finally the association AVIBEP can help you navigate and find the best solution to your case.