Precise Instead of Broad-Spectrum: The Coming Wave of Biological Antibiotics

The development of small-molecule antibiotics in the 1950s has been one of the biggest success stories in modern medicine. These, typically broad-spectrum, antibiotics have contributed to an enormous increase in life expectancy as well as enabled a wide range of modern medical procedures and surgeries. Unfortunately they also have two downsides. One downside are the escalating multi-drug resistances. As the use of these antibiotics went up, the ability of bacteria to evade them has also gone up. The second downside are the many side effects from broad-spectrum antibiotics due to the disruption of the natural microbiomes (e.g. gut, vagina). Both these downsides contribute to an urgent need to find new modes of action against bacterial infections. Going back to nature seems to offer the most promise. Bacteria have co-evolved with bacteriophages for billions of years. Bacteriophages are viruses that hunt, infect and lyse bacteria. Phages have a narrow host range and they are extremely good at keeping bacterial populations in check. It is estimated that every 48 hours, 50% of the world’s bacteria are lysed by phages. Indeed on our own bodies around 10x more phages than bacteria are present. A number of biotech companies are building on this natural principle to develop new classes of antibiotics. Given the unique abilities of phages and phage-derived products to control bacterial infections, these biological antibacterials represent a coming wave of antibiotics that will hopefully yet again have a big impact on human health.