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Bacteriophage products have been included into national clinical recommendations for antimicrobial therapy in urology. Bacteriophages application is approved by expert medical community as a high-potential alternative to chemotherapeutic antimicrobial drugs.
The revision of clinical recommendations for antimicrobial therapy in urology dated 2020 emphasizes that the action of bacteriophage products against urinary tract infections is comparable to the efficiency of antibiotics. However, bacteriophages have advantages over them: they do not inhibit normal flora, do not suppress the body immune defence and do not cause allergy. Thus, in colibacillary, proteus, and staphylococcal urinary tract infection, clinical and bacteriological effect of bacteriophages is reached in 86-93% cases.
According to the recommendations, the use of staphylococcal, streptococcal, proteus, pyocyanic, klebsiellic, colibacillary monobacteriophages as well as combination drugs composed of several bacteriophages is deemed efficient in urologic practice.
Apart from new clinical recommendations in urology, the applicability of bacteriophages is also fixed in the Strategy on Prevention of the Spread of Antimicrobal Resistance in the Russian Federation to 2030 and in the action plan of the strategy implementation approved last year. The document stipulates the development of government regulation in antimicrobials use, development and updating of clinical recommendations in infectious and parasitic diseases taking into account the current therapy protocols, monitoring of the residual quantities of antibiotics in raw food and foodstuffs.
Russian researchers (based on the results of DARMIS-2018) also indicate the growth of Enterobacterales strains resistance to the majority of antimicrobials more than thrice for the last eight years. The most active resistance growth is demonstrated by E. Coli, which is the most common causative agent of urogenital infections: over 70% in Russia. Separate classes of antibiotics have not been yet recommended as a therapy not only due to low microbiological activity, but also because they actively induce resistance.
Bacteriophage products are fully a Russian development. Today in Russia, about 20 titles of medicinal products are released on their basis, including bacteriophages for treatment and prevention of dysentery, salmonellosis, dyspepsia, dysbacteriosis, enterocolitis and a number of other diseases. Commercial manufacture is performed by NPO Microgen at three sites in Ufa, Nizhny Novgorod and Perm (Nacimbio of Rostec State Corporation).