Compassionate Use of Bacteriophages for Failed Persistent Infections During the First 5 Years of the Israeli Phage Therapy Center
Hadil Onallah, Ronen Hazan, Ran Nir‐Paz, Ortal Yerushalmy, Amit Rimon, Ron Braunstein, Daniel Gelman, Sivan Alkalay, Mohanad Abdalrhman, Daniel Stuczynski, Shunit Coppenhagen‐Glazer, Shira Gelman, Leron Khalifa, Karen Adler, Ortal Yerushalmy, Amit Rimon, Ron Braunstein, Sivan Alkalay, Daniel Stuczynski, Shunit Coppenhagen‐Glazer, Mohanad Abdalrhman, Allon E. Moses, Yonatan Oster, Meir Liebergall, Itay Perets, Gurion Rivkin, Yoram A. Weil, Michal Dekel, Ronen Ben‐Ami, Amal Khoury, Daniel Kedar, Suzy Meijer, Nancy Bishouty, Dafna Yahav, Eran Shostak, Gilat Livni
Abstract
The use of bacteriophages (phages) is reemerging as a potential treatment option for antibiotic-resistant or nonresolving bacterial infections. Phages are bacteria-specific viruses that may serve as a personalized therapeutic option with minimal collateral damage to the patient or the microbiome. In 2018 we established the Israeli Phage Therapy Center (IPTC) as a shared initiative of the Hadassah Medical Center and the Hebrew University of Jerusalem, aiming to conduct all of the steps required for phage-based solutions, from phage isolation and characterization to treatments, for nonresolving bacterial infections. So far, a total of 159 requests for phage therapy arrived to the IPTC; 145 of them were from Israel and the rest from other countries. This number of registered requests is growing annually. Multidrug-resistant bacteria accounted for 38% of all phage requests. Respiratory and bone infections were the most prevalent among clinical indications and accounted for 51% of the requests. To date, 20 phage therapy courses were given to 18 patients by the IPTC. In 77.7% (n = 14) of the cases, a favorable clinical outcome of infection remission or recovery was seen. Clearly, establishing an Israeli phage center has led to an increased demand for compassionate use of phages with favorable outcomes for many previously failed infections. As clinical trials are still lacking, publishing patient data from cohort studies is pertinent to establish clinical indications, protocols, and success and failure rates. Last, workflow processes and bottlenecks should be shared to enable faster availability and authorization of phages for clinical use.