Chapter 1 — Antibiotics
Penicillin's discovery (1928) and clinical rollout in the 1940s rewrote medicine. Three decades brought streptomycin, tetracyclines, cephalosporins, macrolidesAminov 2010. Surgery, oncology and transplantation became possible only because we learned to control infection. By the 1980s, infectious disease felt like a closed chapter.
Chapter 2 — The threat
Resistant infections directly kill 1.27 million people each year and contribute to 4.95 million more deathsLancet 2022. ESKAPE pathogens — MRSA, VRE, CRE, ESBL-producing Enterobacteriaceae — are losing susceptibility to every line of defense, including carbapenems and colistin. New antibiotic development has nearly stalled since the 1980s. WHO projects 10 million annual deaths from AMR by 2050O'Neill 2014.
Chapter 3 — Ancient ally
Bacteriophages are the most abundant biological entities on Earth: ~10³¹ particles, an order of magnitude more than all cells combinedMushegian 2020. Independently discovered by Twort (1915) and d'Hérelle (1917) — 13 years before penicillin. Since 1923, the Eliava Institute in Tbilisi has used phage therapy continuously in clinical practice — the only school that survived outside the antibiotic eraEliava Institute.
Chapter 4 — Precision
Phage adsorption is a specific binding between tail fibers and surface receptors (LPS, OmpA, teichoic acids): one phage strain recognizes one bacterial strainNobrega 2018. Unlike broad-spectrum antibiotics, phages don't disturb the commensal microbiome. Phage therapy is compatible with antibiotics and has been used safely in pregnant women and newborns — decades of Eliava clinical experience confirm itSulakvelidze 2001.
Chapter 5 — The future
In Russia, phage preparations (Sextaphage, Pyobacteriophage, Intesti-phage) are registered as medicinal products and have been used for decades — a unique regulatory baseRussian State Drug Registry. In the EU and US, phage therapy is moving through clinical trials (PhagoBurn, Cystic Fibrosis Foundation)PhagoBurn 2019. The frontier: personalized cocktails matched to a patient's strain, ML-driven phage selection from libraries, engineered phages. This is the second line of defense — it works where the first one fails.
Chapter 1 — Antibiotics
Penicillin's discovery (1928) and clinical rollout in the 1940s rewrote medicine. Three decades brought streptomycin, tetracyclines, cephalosporins, macrolidesAminov 2010. Surgery, oncology and transplantation became possible only because we learned to control infection. By the 1980s, infectious disease felt like a closed chapter.
Chapter 2 — The threat
Resistant infections directly kill 1.27 million people each year and contribute to 4.95 million more deathsLancet 2022. ESKAPE pathogens — MRSA, VRE, CRE, ESBL-producing Enterobacteriaceae — are losing susceptibility to every line of defense, including carbapenems and colistin. New antibiotic development has nearly stalled since the 1980s. WHO projects 10 million annual deaths from AMR by 2050O'Neill 2014.
Chapter 3 — Ancient ally
Bacteriophages are the most abundant biological entities on Earth: ~10³¹ particles, an order of magnitude more than all cells combinedMushegian 2020. Independently discovered by Twort (1915) and d'Hérelle (1917) — 13 years before penicillin. Since 1923, the Eliava Institute in Tbilisi has used phage therapy continuously in clinical practice — the only school that survived outside the antibiotic eraEliava Institute.
Chapter 4 — Precision
Phage adsorption is a specific binding between tail fibers and surface receptors (LPS, OmpA, teichoic acids): one phage strain recognizes one bacterial strainNobrega 2018. Unlike broad-spectrum antibiotics, phages don't disturb the commensal microbiome. Phage therapy is compatible with antibiotics and has been used safely in pregnant women and newborns — decades of Eliava clinical experience confirm itSulakvelidze 2001.
Chapter 5 — The future
In Russia, phage preparations (Sextaphage, Pyobacteriophage, Intesti-phage) are registered as medicinal products and have been used for decades — a unique regulatory baseRussian State Drug Registry. In the EU and US, phage therapy is moving through clinical trials (PhagoBurn, Cystic Fibrosis Foundation)PhagoBurn 2019. The frontier: personalized cocktails matched to a patient's strain, ML-driven phage selection from libraries, engineered phages. This is the second line of defense — it works where the first one fails.