Phage therapy for severe bacterial infections: a narrative review

Aleksandra Petrovic Fabijan, Ali Khalid, Susan Maddocks, Josephine Ho, Timothy Gilbey, Indy Sandaradura, Ruby CY Lin, Nouri Ben Zakour, Carola Venturini, Bethany Bowring and Jonathan R Iredell
Med J Aust 2020; 212 (6): . || doi: 10.5694/mja2.50355
Published online: 7 October 2019


  • Bacteriophage (phage) therapy is re‐emerging a century after it began.
  • Activity against antibiotic‐resistant pathogens and a lack of serious side effects make phage therapy an attractive treatment option in refractory bacterial infections.
  • Phages are highly specific for their bacterial targets, but the relationship between in vitro activity and in vivo efficacy remains to be rigorously evaluated.
  • Pharmacokinetic and pharmacodynamic principles of phage therapy are generally based on the classic predator–prey relationship, but numerous other factors contribute to phage clearance and optimal dosing strategies remain unclear.
  • Combinations of fully characterised, exclusively lytic phages prepared under good manufacturing practice are limited in their availability.
  • Safety has been demonstrated but randomised controlled trials are needed to evaluate efficacy.
  • Aleksandra Petrovic Fabijan1,2
  • Ali Khalid1,2,3
  • Susan Maddocks1,3,4
  • Josephine Ho1,2,4
  • Timothy Gilbey5
  • Indy Sandaradura1,3
  • Ruby CY Lin1,2,3
  • Nouri Ben Zakour1,2,3
  • Carola Venturini1,2,3
  • Bethany Bowring1,2
  • Jonathan R Iredell1

  • 1 Centre for Infectious Diseases and Microbiology, Westmead Hospital, Sydney, NSW
  • 2 Westmead Institute for Medical Research, Sydney, NSW
  • 3 University of Sydney, Sydney, NSW
  • 4 Westmead Hospital, Sydney, NSW
  • 5 Wagga Wagga Base Hospital, Wagga Wagga, NSW


This work is supported by grants (1104232 and 1107322) from the Australian National Health and Medical Research Council. AmpliPhi Biosciences Corporation partially contributed to the funding of a bacteriophage therapy investigator‐led clinical trial at Westmead Hospital and Westmead Institute for Medical Research.

Competing interests:

No relevant disclosures.


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