In July 2018, the Journal of Trauma and Acute Care Surgery published a review* devoted to the history and prospects of using bacteriophages in military medicine.

The review's authors are scientists from the Hebrew University (Jerusalem, Israel) and the Eliava Institute of Bacteriophages, Microbiology, and Virology (Tbilisi, Georgia). The review discusses the high potential of phage therapy as a treatment for antibiotic-resistant infections in military medicine. The authors believe that the introduction of phage therapy into military medicine is a necessary step, given the spread of antibiotic resistance in bacteria.

According to the authors of the article, lytic bacteriophages have a number of properties that make them effective and reliable therapeutic agents for use both independently and in combination with antibiotics:

- the ability to "auto-dose" (bacteriophages in the infection site multiply more actively, the more pathogenic bacteria there are. After the pathogens are eliminated, bacteriophages gradually disappear);

- specificity (bacteriophages affect a narrow range of host bacteria - one species or even strain, therefore, unlike antibiotics, they do not disrupt the patient’s normal microbiome);

- bacterial resistance to bacteriophages, as well as to antibiotics, can develop, but it is easy to resist (searching for and isolating new phages that would be active against a specific antibiotic-resistant or other phages of the pathogen is a relatively simple process);

- the ability to penetrate biofilms (bacteria that form protective biofilms from exopolysaccharides often lose sensitivity to antibiotics, but not to bacteriophages that can destroy them).

The authors of the review see the following areas of application of phage preparations in military medicine:

- Treatment of wound infections, which are often caused by multi-resistant strains of pathogenic bacteria, in particular Staphylococcus aureus (MRSA), Acinetobacter baumannii, Pseudomonas aeruginosa ;

- Therapy of burns, burn wound infections;

- Treatment of osteomyelitis, which is often caused by biofilm-forming bacteria and resistant Staphylococci ;

- Prevention and treatment of intestinal infections (shigellosis, salmonellosis, etc.), which are associated with military actions, disruptions of sanitary communications, and large crowds of people;

- Prevention and treatment of infections that can be used in biological terrorism ( Bacillus anthracis, Yersinia pestis, Francisella tularensis , etc.).

The review presents data from modern laboratory and clinical studies on the use of phages in the indicated areas.

* Gelman D, Eisenkraft A, Chanishvili N, Nachman D, Coppenhagem Glazer S, Hazan R. The history and promising future of phage therapy in the military service // J Trauma Acute Care Surg, 2018, 85(1S Suppl 2) : S18-S26 . doi: 10.1097/TA.0000000000001809.