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Viruses. 2018 Dec 28;11(1). pii: E18. doi: 10.3390/v11010018.

Clinical Indications and Compassionate Use of Phage Therapy: Personal Experience and Literature Review with a Focus on Osteoarticular Infections.

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Service of Infectious and Tropical Diseases, CHI Lucie et Raymond Aubrac, 94190 Villeneuve Saint Georges, France.
Department of Musculoskeletal Medicine DAL, Centre Hospitalier Universitaire Vaudois CHUV, Service of Plastic, Reconstructive & Hand Surgery, Regenerative Therapy Unit (UTR), CHUV-EPCR/Croisettes 22, 1066 Epalinges, Switzerland.
HGM Consultants, 63 Rebecca Parade, Winston Hills, NSW 2153, Australia.
School of Life Sciences, University of Technology, Ultimo, NSW 2007, Australia.
Cellabs Pty Ltd, and Founder Special Phage Services Pty Ltd, both of 7/27 Dale St, Brookvale, NSW 2100, Australia.
Service of Infectious and Tropical Diseases, CHI Lucie et Raymond Aubrac, 94190 Villeneuve Saint Georges, France.


The history of phage therapy started with its first clinical application in 1919 and continues its development to this day. Phages continue to lack any market approval in Western medicine as a recognized drug, but are increasingly used as an experimental therapy for the compassionate treatment of patients experiencing antibiotic failure. The few formal experimental phage clinical trials that have been completed to date have produced inconclusive results on the efficacy of phage therapy, which contradicts the many successful treatment outcomes observed in historical accounts and recent individual case reports. It would therefore be wise to identify why such a discordance exists between trials and compassionate use in order to better develop future phage treatment and clinical applications. The multitude of observations reported over the years in the literature constitutes an invaluable experience, and we add to this by presenting a number of cases of patients treated compassionately with phages throughout the past decade with a focus on osteoarticular infections. Additionally, an abundance of scientific literature into phage-related areas is transforming our knowledge base, creating a greater understanding that should be applied for future clinical applications. Due to the increasing number of treatment failures anticipatedfrom the perspective of a possible post-antibiotic era, we believe that the introduction of bacteriophages into the therapeutic arsenal seems a scientifically sound and eminently practicable consideration today as a substitute or adjuvant to antibiotic therapy.


antibiotic resistance; antibiotic therapy; bacterial infection; bacteriophage; cases report; phage therapy

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