By Clare Murphy

BBC News health reporter



Red Army soldiers used bacteriophages against gangrene

In the 1930s, a war was on. A new treatment for bacterial infections - antibiotics - was seeking to assert its supremacy over another fledgling therapy - a bacteria-devouring virus called a bacteriophage.

In the West, it was Alexander Fleming's antibiotic which won the day: penicillin was effective and widely available thanks to synthetic production.

The initial euphoria around the bacteriophage as a means of combating what had been incurable conditions subsided and the virus was all but forgotten.

But not in Stalin's Soviet Union, where a research programme was pioneered in his homeland of Georgia. Even today, the bacteriophage is used as standard treatment in parts of Eastern Europe for bacterial infections from gangrene to strep throat.

Meanwhile in the West, the love affair with antibiotics is drawing to a close.

Overuse means many bacteria have become resistant to many forms of the treatment, and the willingness of drug firms to bring new brands onto the market appears to be faltering. It can cost as much as £400m ($800m) to develop the drug and take as long as ten years.

The frantic search for an alternative treatment amid dire warnings that we are on the brink of returning to a pre-antibiotic era means the bacteriophage which was dismissed decades ago may yet have its day.

Latching on

What has long made antibiotics so appealing is the fact that they eliminate so many types of bacteria in one go. Phages are more complicated: a certain type has to be found to combat each infection.

BACTERIOPHAGE HISTORY 1896: Ernest Hankin notes Indian rivers possess anti-bacterial properties 1915: Frederick Twort discovers a "bacteria virus" 1917: Felix d'Herelle makes same observations, calls them "bacteriophages" 1923: Eliava Institute founded in Georgia 1925: Four patients with bubonic plague successfully treated

"But it's this specificity which makes them so attractive," says Dr Ron Dixon, Head of the Department of Forensic and Biomedical Sciences at Lincoln University. "It will only kill the bacteria you want it to."

The word bacteriophage literally means "to eat bacteria".

Once the phage has entered the body, it attaches itself to the bacteria causing the infection, and shoots in its own DNA to make the bacteria start producing bacteriophages. Within 30 minutes, up to 200 new phage are created, according to Dr Dixon, and in the process the bacteria die.

The job done, the phage automatically start to disappear.

And if the bacteria become resistant to the phage, as they have done to antibiotics, a new phage matched to the new bacteria can be developed. In order to inhibit resistance, a cocktail of phages would most likely be used in treatment.

There are no known side-effects, researchers stress, although there were significant numbers of deaths in the 1930s and 1940s.

Those pioneering this 21st Century drive to promote the therapy say these were mainly the result of a failure to understand the biology of phages, inaccurate diagnoses of patients in the first place and poor manufacturing procedures.

What next?

Nonetheless, few Western companies have so far ventured into the field of bacteriophage therapy.

It will only kill the bacteria you want it to

Dr Ron Dixon

Dr Nick Housby of Novolytics Limited - one firm which has - says this is because of the intellectual property rights surrounding the therapy, which has so long been used elsewhere. Phages are notoriously hard to patent, the process by which drug companies secure their future profits.

Novolytics is currently working on a cream which they say could combat MRSA. Inserted into the nose, where MRSA bacteria frequently linger, it is hoped the cream could combat more than 15 strains of the condition.

But it still needs to be subjected to two phases of clinical testing, and even if these proved it successful, it may take as many as five years for the cream to hit the market.

Separately, researchers are working with the Eliava Institute in Georgia, where an MRSA fighting phage has been developed, to see if it could have applications in the UK.