Sourcing phages for compassionate use

Antibiotic resistance is a phenomenon that knows no geographical borders, so addressing this crisis is a worldwide public health priority. While total global resistance rates are difficult to estimate and vary between countries, an international report asserts that the development of new antibacterials is essential to ensuring the future ability to treat bacterial infections1. Bacteriophage (phage) therapy is a likely contributor to resolving potentially devastating effects of antibiotic resistance, yet no phage product currently holds a marketing authorisation that would permit their free use in clinical medicine outside of former countries of the Soviet Union, where phage therapy is a long-standing practice2,3. In the interim, the compassionate use of phage therapy (cPT) remains a possible treatment avenue for cases of antibiotic failure, and several competency centres, physicians, and researchers have achieved therapeutic benefits with this option. As antibiotic resistance continues to rise, there is much to be done in order to streamline cPT efforts, particularly in terms of phage sourcing, in order to reach more patients in an efficient, effective, and safe manner. This article highlights how cPT can be coordinated, and describes the experience of cPT in Australia.