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Comment by donavanm | Hacker News Reader

IIRC the most usage is romania and bulgaria(?), not russia.

As to why not, they dont “scale out” like other generalized pharmaceuticals or medicine. Phages need a bunch of patient specific diagnostics and revision to be effective against the specific target. Thats why you see people fly to romania for a month of treatment, and not order the bacteriophages from romania.

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This isn't terribly different than the latest precision medicine in the US. For example, drugs like Keytruda can only be used in the presence or absence of certain genetic markers in the tumor. Most cutting edge immunotherapy is similar; they require patient specific diagnoses and sometimes revisions.

These therapies are the largest focus of cancer research in the US right now with enormous funding behind them, despite having the same weaknesses you point out as bacteriophages.

Do bacteriophages work against cancer?

Not in themselves. But they can apparently be used as a delivery mechanism in cancer related gene therapy.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9697857/

Well in this case the bacterium is (accounting for mutations which might happen) more or less the same, not some antibiotic-resistant "super-bug". But I guess most phage research has gone into phages that attack bacteria which cause disease in humans, not in trees, so some further research would be needed? And such research seems to be indeed going on: https://pmc.ncbi.nlm.nih.gov/articles/PMC3911242/ "We report the isolation and characterization of the first virulent phages for X. fastidiosa, siphophages Sano and Salvo and podophages Prado and Paz, with a host range that includes Xanthomonas spp."

> Thats why you see people fly to romania for a month of treatment

I had no idea people did this!

Now I wonder, how do you fly to Romania while infected with MRSA? Med evac only, or can you board a commercial flight?

Note that "MRSA is endemic in the United States, with the CDC estimating a 2% rate of carriage in the general population".

I'm not sure what questions get asked on entry to Romania...

What kind of diseases do people have who go for such treatments?

The cases I've heard of were all antibiotic-resistant infections.

"The Good Virus", by Tom Ireland, is an entertaining book about bacteriophage therapies, their history, and why they're difficult to scale up.

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