History Part 12 : Post-War Stagnation and Phage Therapy’s Marginalization in the West (1945–1980s)

Post-War Stagnation and Phage Therapy’s Marginalization in the West (1945–1980s)

The period following World War II marked a decisive turning point in the trajectory of phage therapy in Western medicine. Despite the promising results bacteriophages had demonstrated prior to the war as potential antibacterial agents, the decades after 1945 saw a dramatic decline in interest, funding, and scientific engagement with phage therapy in the United States and much of Western Europe. This marginalization can be attributed to a confluence of scientific, sociopolitical, and economic factors that reshaped the landscape of infectious disease treatment and research.

Artistic View

One of the key contributors to this decline was the overwhelming optimism surrounding the newly discovered class of antibiotics. The post-war pharmaceutical revolution brought forward a series of broad-spectrum antibiotics such as streptomycin, tetracycline, and chloramphenicol, which were viewed as miracle drugs capable of rapidly curing bacterial infections. These drugs were easier to standardize, mass-produce, and distribute compared to phage preparations, which were perceived as complex biological agents with inconsistent effects. This created a strong bias within medical communities and regulatory bodies toward antibiotic-based therapies.

At the same time, phage therapy was hampered by methodological challenges that weakened its scientific credibility in the eyes of Western researchers. Clinical trials conducted during this period often suffered from poor design, lack of proper controls, and insufficient characterization of phage preparations. The inherent complexity of phages—viruses that specifically infect bacteria—introduced difficulties in standardizing dosages and ensuring reproducibility. Additionally, the specificity of phages to certain bacterial strains posed logistical problems for clinicians faced with infections caused by diverse or evolving bacterial populations.

Despite these obstacles, isolated pockets of research persisted. Some Western laboratories attempted to refine phage production and purification techniques, aiming to address the heterogeneity that plagued earlier studies. For instance, advances in electron microscopy allowed for better visualization and classification of phages, while emerging molecular biology techniques provided initial insights into phage genetics. Yet, these efforts remained marginal and failed to shift the broader medical consensus.

An intriguing anecdote from this era involves the U.S. Navy, which, in the late 1940s, explored phage therapy for treating infections in wounded soldiers returning from the Pacific theater. Reports indicate that in some cases, phages were administered to combat antibiotic-resistant infections, with mixed outcomes. However, these initiatives were largely experimental and did not lead to sustained integration into military medicine or mainstream healthcare.

Publications from this time also reveal skepticism from leading infectious disease specialists who criticized phage therapy for lacking rigorous clinical evidence. A 1954 review in a prominent medical journal underscored the absence of double-blind, placebo-controlled trials and questioned the reproducibility of reported successes. This skepticism translated into diminished funding for phage research, as grant agencies and pharmaceutical companies prioritized antibiotic development, perceived as more scientifically tractable and commercially viable.

Interestingly, during this period, the scientific community’s understanding of bacterial resistance was still nascent. The phenomenon of multidrug-resistant bacteria, now a global health threat, had not yet become widely apparent. As a result, there was little perceived urgency to explore alternative antibacterial strategies such as phages, reinforcing their sidelining.

By the late 1970s, while phage therapy had virtually disappeared from Western clinical practice, it had by no means been forgotten entirely. Scientific curiosity about bacteriophages endured in more fundamental research contexts, such as molecular genetics, where phages played a pivotal role in the discovery of gene regulation and the nature of DNA. This paradoxically meant that while phages were invaluable to biological science, their potential as therapeutic agents remained underappreciated.

In conclusion, the decades following World War II saw phage therapy relegated to the margins of Western medicine due to a complex interplay of scientific skepticism, methodological hurdles, and the rapid ascendancy of antibiotics. Although some isolated efforts persisted, the general trend was a stagnation of phage research and clinical application in the West. This period would last until the resurgence of interest in the 1980s and beyond, driven by the growing threat of antibiotic resistance and technological advances. Understanding this historical context is essential to appreciating the contemporary renaissance of phage therapy.

References :

Chanishvili, N. (2012). Phage therapy—history from Twort and d’Hérelle through Soviet experience to current approaches. Advances in Virus Research, 83, 3-40.

Summers, W. C. (2012). The bacteriophage and its role in immunology. In The bacteriophage: its role in immunology (pp. 233-256). Springer.

Sulakvelidze, A., Alavidze, Z., & Morris, J. G. Jr. (2001). Bacteriophage therapy. Antimicrobial Agents and Chemotherapy, 45(3), 649–659.

Wittebole, X., De Roock, S., & Opal, S. M. (2014). A historical overview of bacteriophage therapy as an alternative to antibiotics for the treatment of bacterial pathogens. Virulence, 5(1), 226-235.