Emerging treatments
Phage therapy
Bacteriophages are viruses that infect bacterial cells, making them more vulnerable to the host's immune system or antibiotics. Oral coliphage therapy (a bacteriophage that infects coliform bacteria) was reported to be safe in one randomised trial of Bangladeshi children hospitalised with acute bacterial diarrhoea, 60% of whom had microbiologically proven Escherichia coli diarrhoea.[56] However, coliphage therapy failed to improve diarrhoea outcome in this study.
Vaccines
It has been hypothesised that a cholera vaccine (Dukoral®) may be effective against enterotoxigenic E coli(ETEC) because the recombinant subunit of the cholera toxin is antigenically similar to the heat labile toxin of ETEC. One Cochrane review failed to identify any statistically significant preventive effect of ETEC vaccinations on ETEC diarrhoea or all-cause diarrhoea.[57] A subsequent phase 2 randomised control trial of a bioconjugate vaccine directed against the O-antigen of specific E coli serotypes reported a robust, functional antibody response among healthy adults; the vaccine appeared to be well tolerated.[58] Further research is required.
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