The race to beat antibiotic resistance is on – so where do phages fit in? | Richard James

The GM virus treatment that saved Isabelle Holdaway is a start, at least, in the fight against drug resistance

The first antibiotic was discovered by Paul Ehrlich in 1909 and cured syphilis-infected rabbits. At that time about 10% of the population of London were infected with syphilis and there were no effective treatments. Despite the tedious injection procedure and side effects, Salvarsan, together with the less toxic derivative Neosalvarsan, enjoyed the status of the most frequently prescribed drug until its replacement by penicillin in the 1940s. The postwar period was the beginning of a 20-year golden age of antibiotic discovery, with a large number of effective new antibiotics entering into clinical use.

But the problem of antibiotic resistance has been increasingly recognised over the past 30 years, with the chief medical officer of England, Dame Sally Davies, in 2018 repeating her warning of the post-antibiotic apocalypse facing modern medicine as we run out of effective antibiotics to treat life- threatening infections. The recent success in treating 17-year-old Isabelle Holdaway – who was left with an infection that could not be cleared by antibiotics after a lung transplant – with bacteria-killing viruses offers some hope. But it also raises the question as to how this therapy works and whether it can help to overcome the problem of antibiotic resistance.

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