Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 25, Number 7—July 2019
Books and Media

Bugs as Drugs: Therapeutic Microbes for the Prevention and Treatment of Disease

Article Metrics

Cite This Article

Robert A. Britton; Patrice D. Cani, editors
ASM Press, Washington, DC, USA, 2018
ISBN-10: 1555819699; ISBN-13: 978-1555819699; e-ISBN: 978-1555819705
Pages: 514; Price: $120.00


Thumbnail of Bugs as Drugs: Therapeutic Microbes for the Prevention and Treatment of Disease

Figure. Bugs as Drugs: Therapeutic Microbes for the Prevention and Treatment of Disease

The role of microbes and the microbiome in various aspects of human health and disease is a subject of ongoing intense study. The complexity of microbial communities and their interactions with the host present exceptional challenges for conducting these investigations that will require multipronged strategies to resolve. As the field undergoes the much-needed transition beyond association studies to a mechanistic understanding of how microbes influence their hosts, manipulating commensal microbes and using them for diagnostics and therapeutic interventions is the logical next step. Because microbiome research studies are being published at an unprecedented rate, a reliable book that reviews the seminal work and knowledge gaps in this field is pressingly needed. In Bugs as Drugs: Therapeutic Microbes for the Prevention and Treatment of Disease (Figure), the authors address major themes in microbiome research, particularly focusing on therapeutic applications.

This ≈500-page volume, edited by Robert A. Britton and Patrice D. Cani, comprises 5 main sections of varying scope and length. The introductory section reviews pathways used by commensals, particularly Lactobacilli and Bifidobacteria spp., to benefit the host. The first chapter is particularly impressive, providing a thorough and well-cited overview of the various microbial metabolites and how they influence the host.

The theme of section 2, the longest and most wide-ranging part, is the role of the microbiome in chronic diseases. Given the ambitious scope of this section, the authors selectively covered a range of diseases (from nutritional disorders to colorectal cancer and osteoporosis) for which the host–microbe interactions have been described. Although this section might seem fragmented, it succeeds in providing the reader with a sense of the breadth of diseases in which therapeutic microbes might play a role. When links between microbes or the microbiome and human ailments are tentative or controversial, the authors do a sound job describing the conflicting reports within their respective fields.

Section 3 covers the vital function of the gut microbiome, namely the control of infectious diseases, with a focus on Clostridioides difficile and Enterococcus spp. infections. In this section, the authors tackle the seminal studies of fecal microbiota transplantation to control C. difficile infections and questions that need to be answered to evaluate the long-term consequences of this therapy, extending beyond C. difficile control.

Section 4 provides insight on the tools and techniques used to study and manipulate the microbiome, including strategies to genetically modify microbiota to design diagnostics and therapeutic applications, innovative genetic tools to engineer probiotics, and CRISPR (clustered regularly interspaced short palindromic repeats) technologies to modify microbes. Moreover, a chapter in this section is devoted to reviewing US regulatory considerations for developing live biotherapeutics-based drugs; however, regulatory constraints outside the United States are not covered in the book. The final section covers indirect strategies to functionally target the gut microbiome, including the use of bacteriophages as antibacterial agents and prebiotics to modulate the microbiome.

Overall, this book is a commendable and timely volume of well-sourced reviews written by experts in the field well organized into broad research themes. This work will serve as a helpful resource for both scientists and clinicians interested in using microbes for therapeutic applications.



A.S.B. is supported by the Damon Runyon Cancer Research Foundation, Emerson Collective, and a Baxter Foundation fellowship.


Soumaya Zlitni and Ami S. BhattComments to Author 
Author affiliations: Stanford University, Stanford, California, USA




Cite This Article

DOI: 10.3201/eid2507.190582

Original Publication Date: May 29, 2019

Related Links


Table of Contents – Volume 25, Number 7—July 2019

EID Search Options
presentation_01 Advanced Article Search – Search articles by author and/or keyword.
presentation_01 Articles by Country Search – Search articles by the topic country.
presentation_01 Article Type Search – Search articles by article type and issue.



Please use the form below to submit correspondence to the authors or contact them at the following address:

Ami S. Bhatt, 269 Campus Dr, Department of Medicine (Hematology, Blood, and Marrow Transplantation) and Department of Genetics, Stanford University, Stanford, CA 94305, USA

Send To

10000 character(s) remaining.


Page created: June 17, 2019
Page updated: June 17, 2019
Page reviewed: June 17, 2019
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.