Current State of Compassionate Phage Therapy
Unit of Regenerative Medicine, Department of Musculoskeletal Medicine, Service of Plastic, Reconstructive, & Hand Surgery, University Hospital of Lausanne (CHUV), 1066 Epalignes, Switzerland
Swiss Federal Institute of Technology Lausanne (EPFL), 1015 Lausanne, Switzerland
Phage Directory, Atlanta, GA 30303, USA
Yale University, New Haven, CT 06520, USA
Author to whom correspondence should be addressed.
Viruses 2019, 11(4), 343; https://doi.org/10.3390/v11040343
Received: 1 March 2019 / Revised: 4 April 2019 / Accepted: 6 April 2019 / Published: 12 April 2019
(This article belongs to the Special Issue Hurdles for Phage Therapy (PT) to Become a Reality)
There is a current unmet medical need for the treatment of antibiotic-resistant infections, and in the absence of approved alternatives, some clinicians are turning to empirical ones, such as phage therapy, for compassionate treatment. Phage therapy is ideal for compassionate use due to its long-standing historical use and publications, apparent lack of adverse effects, and solid support by fundamental research. Increased media coverage and peer-reviewed articles have given rise to a more widespread familiarity with its therapeutic potential. However, compassionate phage therapy (cPT) remains limited to a small number of experimental treatment centers or associated with individual physicians and researchers. It is possible, with the creation of guidelines and a greater central coordination, that cPT could reach more of those in need, starting by increasing the availability of phages. Subsequent steps, particularly production and purification, are difficult to scale, and treatment paradigms stand highly variable between cases, or are frequently not reported. This article serves both to synopsize cPT publications to date and to discuss currently available phage sources for cPT. As the antibiotic resistance crisis continues to grow and the future of phage therapy clinical trials remains undetermined, cPT represents a possibility for bridging the gap between current treatment failures and future approved alternatives. Streamlining the process of cPT will help to ensure high quality, therapeutically-beneficial, and safe treatment.