Phage therapy and the public: Increasing awareness essential to widespread use

Today, the antimicrobial resistance (AMR) crisis is shaping a world where previously treatable infections can kill. This has revitalised the development of antibiotic alternatives, such as phage therapy. The therapeutic use of phages, viruses that infect and kill bacteria, was first explored over a century ago. However, most of the Western world abandoned phage therapy in favour of antibiotics. While the technical feasibility of phage therapy has been increasingly investigated in recent years, there has been minimal effort to understand and tackle the social challenges that may hinder its development and implementation. In this study, we assess the UK public's awareness, acceptance, preferences and opinions regarding phage therapy using a survey, fielded on the Prolific online research platform. The survey contained two embedded experiments: a conjoint and framing experiment (N = 787). We demonstrate that acceptance of phage therapy among the lay public is already moderate, with a mean likelihood of acceptance of 4.71 on a scale of 1 (not at all likely to accept phage therapy) to 7 (very likely to accept phage therapy). However, priming participants to think about novel medicines and antibiotic resistance significantly increases their likelihood of using phage therapy. Moreover, the conjoint experiment reveals that success and side effect rate, treatment duration, and where the medicine has been approved for use has a statistically significant effect on participants' treatment preferences. Investigations altering the framing of phage therapy, to highlight positive and negative aspects, reveal a higher acceptance of the treatment when described without using perceived harsh words, such as kill and virus. Combined, this information provides an initial insight into how phage therapy could be developed and introduced in the UK to maximise acceptance rate.

Automated summary

The antimicrobial resistance crisis is leading to a world where previously treatable infections can be deadly. Phage therapy, which uses viruses to kill bacteria, is being explored as an alternative to antibiotics. However, little attention has been paid to the social challenges that may hinder the development and implementation of phage therapy. This study assesses the UK public's awareness, acceptance, preferences, and opinions regarding phage therapy through a survey. The results show that the public's acceptance of phage therapy is moderate and can be increased through priming participants to think about novel medicines and antibiotic resistance. Factors such as success rate, side effect rate, treatment duration, and approval for use affect participants' treatment preferences. Framing phage therapy without using harsh words leads to higher acceptance rates.