Terapia fagica come una potenziale soluzione per superare la resistenza agli antibiotici dei batteri relativa alle infezioni cliniche

The introduction of antibiotics in the mid-twentieth century is arguably one the most important event in the history of medicine in regard to decreasing human morbidity and mortality. However, the constant abuse of antibiotics, not only in medicine but also in industrial, zootechnical and agricultural fields, has accelerated the emergence and the spread of antibiotic-resistant bacteria. As the frequency of this bacterial resistance grows higher, we face more and more challenges, increasing the cost of antibiotic applications in every field and decreasing the effectiveness of treatments against infections. It is well known that bacteria can develop resistance to our current medical treatments and giving enough time this resistance may become total (pan-drug resistance); at this point the post-antibiotic era will have begun, in which common infections and minor injuries can once again kill. During the last decades we have faced a significant increase of AMR (antimicrobial resistance) in clinical cases, making infections harder to treat and slowly increasing the risk of disease spread, severe illness and death. In rare cases even MDR (multi-drug resistant) bacteria have been spotted and it is just a matter of time before we will encounter PDR (pan-drug resistant) bacteria. To avoid this event, it is necessary to put an end to the abuse of antibiotics and begin the implement of alternative treatments, totally replacing the antibiotics. Where it is impossible to achieve this goal, it is imperative to minimize the chances of resistance occurring, made viable using compounds that act as adjuvants of antibiotics. This thesis treats the mechanisms behind the spread of AMR in bacteria and how the bacteriophage therapy may represent a solution as a replacement to antibiotics and even as an adjuvant of antibiotic activity, viewing the advantages and disadvantages of the different phage-based treatments in correlation to their actual availability in regard to the current regulatory framework.