Evidence-Based Medicine Matters

Geoff Hanlon

President, Society for Applied Microbiology

To those of us working within the modern scientific community the idea of applying a process without fully validating it beforehand would be unthinkable. Unfortunately we have been plagued for centuries by quacks peddling unproven remedies to a vulnerable population. I have an interest in the application of novel alternatives to antibiotics for treating bacterial infections. This is particularly pertinent in the light of increasing antibiotic resistance. One approach is the use of bacteriophages (bacterial viruses), a process that emerged in the 1920s before antibiotics were available. At that time contracting a bacterial infection could easily result in death and so not surprisingly the public were ready to embrace any therapy that showed promise. Unfortunately a number of pharmaceutical companies began marketing products before the active principles of this new technology had even been established much less tested for safety and efficacy. Outrageous claims were made for the range of conditions capable of being treated most of which had nothing to do with bacteria and were simply a work of fiction. The sad fact is that bacteriophage therapy was effective and yet the erosion of confidence in the eyes of the public and the established medical community by the lack of an evidence-based approach has lasted over eight decades. Scientists now are trying to repair the damage done in the early years to establish without doubt the efficacy of the process and to properly investigate the potential of bacteriophage therapy so that, if appropriate, it may be re-introduced into the clinic.