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 randomized trial of Bangladeshi children hospitalized with acute bacterial diarrhea, 60% of whom had microbiologically proven Escherichia coli diarrhea.[58] However, coliphage therapy failed to improve diarrhea outcome in this study.
Vaccines
It has been hypothesized 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 diarrhea or all-cause diarrhea.[59] A subsequent phase 2 randomized 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.[60] Further research is required.
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