The journal EMBO Molecular Medicine describes* a clinical case of successful phage therapy for an antibiotic-resistant bacterial infection in a child. The successful treatment helped avoid limb amputation.

In the article “Bacterial lysis, autophagy, and the innate immune response during concomitant phage therapy in a child,” scientists from Australia, Israel, and the United States describe a clinical case*:

As a result of a car accident, the patient, a 7-year-old girl, sustained injuries, including bone fractures. Intramedullary fixation was used to treat the leg fracture. The surgery was complicated by the development of a Pseudomonas aeruginosa osteoarticular infection. Surgical debridement, removal of the fixators, and a three-month course of intravenous antibiotics failed to cure the infection.

To prevent limb amputation, a decision was made to use phage therapy. A phage preparation specific to the Pseudomonas aeruginosa strain isolated from the patient was manufactured by specialists at the biotechnology company Adaptive Phage Therapeutics (APT). The authors of the article note that a significant therapeutic effect was observed within two weeks of starting concomitant phage therapy.

The patient received the phage preparation for two weeks at 0.9 ml intravenously once daily (days 1, 2, and 4-7) or twice daily (days 3, 8-14). Phage and bacterial kinetics were monitored throughout treatment to adjust the dose if necessary.

The study authors note that fever, local pain, and activation of genes associated with autophagy and nonspecific immunity were observed at the beginning of phage therapy. A mild fever also accompanied the second and third administrations of the phage preparation but subsequently subsided. Painless weight-bearing of the affected limb was achieved (for the first time since the injury) seven weeks after completion of phage therapy. There were no symptoms of infection during the five-month follow-up period after completion of phage therapy.

"This case is further clinical evidence of the significant potential of specific phage therapy in the fight against antibiotic-resistant infections," noted Greg Merril, co-CEO of APT. The company is making significant efforts to improve access to phage products for patients and to conduct clinical trials of phage therapy in accordance with evidence-based medicine.

* Khatami A, Lin RCY, Petrovic-Fabijan A, Alkalay-Oren S et al. Bacterial lysis, autophagy and innate immune responses during adjunctive phage therapy in a child // EMBO Mol Med, 2021; 13:e13936. https://doi.org/10.15252/emmm.202113936