Broad spectrum delivery

Smithyman foresees a time when broad spectrum phages will be developed for immediate use once a patient presents with an infection. He also sees a time when patient-specific phages are produced for particular infections.

“If it is extremely urgent they will be hit with a broad spectrum, but before that you take a swab and isolate the type of infection, take that isolate and run it past a vast collection of phages, choose the right one and then grow it up quickly. In a couple of days the patient can be treated with their own specific phages.”

Delivery options are as versatile as the phages, he says. “The patient at Westmead was infused because we had to decide how to get the phages into the bladder, so a catheter was chosen. But normally they would be used in liquid form embedded in bandages, or as a tablet for straightforward oral delivery. We have also formulated a cream, and another way they will be used is through a nebulliser.”

Phages are extraordinarily powerful but obviously they won’t cure everything, particularly if there are co-morbidities. And they probably will meet the brick wall of bacterial resistance, just as antibiotics have done.

“That’s why we are developing cocktails – bacteria might become resistant to one type of phage, but not to many.”

And the market is potentially huge. As Smithyman points out, the large pharmaceuticals have been walking away from trying to develop new antibiotics over the last couple of years because there isn’t much profit in it, leaving it up to the smaller and generic pharma companies to look for biotechs to come up with novel ideas for antibiotics.

It is a $24 billion a year sector that is becoming a vacuum, he says, and perhaps phages are the right organism to fill it.