Phage therapy for severe infections tested in the first multicentre trial.

1384 www.thelancet.com/infection Vol 15 December 2015 It is common knowledge that antibiotic resistance is one of this century’s most important medical challenges. Journalists often speculate about a dystopian post-antibiotic future and, in 2014, the public chose combating it as the challenge for the £10 million Longitude Prize. Yet one potential alternative to antibiotics has been in clinical use for almost a century. This is phage therapy: the use of viruses that specifi cally infect and destroy bacteria to treat refractory infections. The fi rst paper to describe bacteriophages was published by Frederick Twort in the Lancet in 1915. He referred to bacteriophages as “the transmissible bacterial lyses”. 4 years later, and still 10 years before the discovery of penicillin, they were fi rst used as anti-infective agents. However, phage therapy stalled in developed countries after penicillin was discovered. During and immediately after the Cold War, use of bacteriophages was restricted to some countries in eastern Europe, largely because of the diffi culty in obtaining antibiotics there. “We have decades of experience of this approach in Poland, and anecdotal evidence of its effi cacy and safety, but this has not been rigorous enough to enable any phage therapy to be licensed”, says Andrzej Górski of the L Hirszfeld Institute of Immunology and Experimental Therapy (Wroclaw, Poland).