Melbourne Monash researchers pioneer personalised phage therapy for patients with drug-resistant bacterial infections

VICPhage programme has reported early clinical findings that refine personalised bacteriophage therapy, with implications for treatment of multidrug-resistant infections

A research team in Melbourne, Australia, has pioneered a personalised bacteriophage therapy approach that has begun to reshape how clinicians treat life-threatening infections resistant to conventional antibiotics.

The VICPhage initiative – a clinical partnership between The Alfred Hospital, part of the Alfred Health network, and Monash University – has established one of the first end-to-end phage therapy programmes in Australia. The platform has combined compassionate-use clinical delivery with translational research and participation in multicentre clinical trials, in an effort to address the escalating global burden of antimicrobial resistance (AMR).

Phage therapy involves the administration of bacteriophages which are viruses that can selectively infect and destroy bacteria. Although the concept has existed since the early twentieth century, it has regained scientific and clinical attention as antibiotic resistance has intensified. The VICPhage programme has sought to modernise this approach through genomic characterisation, precision matching of phages to bacterial pathogens and integration with regulatory frameworks.

Professor Anton Peleg, director of the department of infectious diseases at The Alfred and Monash University and a senior author of the study, emphasised the importance of revisiting historical therapies through a contemporary scientific lens.

“Phages were actually first used early in the 1900s but were effectively cast aside with the introduction of antibiotics,” said Peleg said.

“As we now face the growing threat of AMR, research [for] alternatives – such as phage therapy – is critically important to modern medicine.

“The work we are doing builds on the foundation of generations past but takes advantage of significant innovations in science and technology to harness its potential for personalised treatments that could revolutionise how clinicians treat infectious disease,” he said.

The study has detailed a landmark case from 2022, which represented the first documented clinical application of phage therapy in the Australian state of Victoria. The patient, aged 22 years and diagnosed with cystic fibrosis, had experienced persistent and severe infections caused by a bacterial strain which was resistant to treatment by almost all available antibiotics. Such cases illustrate the clinical urgency that has driven renewed interest in bacteriophage-based interventions.

Before clinicians can administer phage therapy in Australia, they must obtain approval from the national medicines regulatory body – Therapeutic Goods Administration – under compassionate-use provisions. This process requires demonstration that standard treatments have failed and that the infection poses an immediate threat to life, limb or physiological function. This regulatory pathway ensures careful oversight while still enabling access to novel therapies for critically ill patients.

Dr Fernando Gordillo-Altamirano, first author of the study and a postdoctoral researcher within the Peleg Phage Translational Laboratory, reported that the initial case yielded insights that have direct implications for patient selection and therapeutic design.

“We discovered that phage therapy did not work in this patient because he had pre-existing antibodies against the phage,” said Gordillo-Altamirano.

“These antibodies destroyed the phages before they could kill the infection. We were swiftly able to determine how to test subsequent patients to see if they already have antibodies against particular phages, in order to adapt our treatment,” he added.

This observation has underscored a central challenge in phage therapy – host immune responses can neutralise therapeutic viruses before they reach their bacterial targets. The VICPhage team has therefore begun to incorporate immunological screening into its workflow, to refine patient stratification and improve the likelihood of clinical success.

Professor Jeremy Barr, co-lead of VICPhage and head of the Monash Phage Foundry (MPF), has highlighted the broader translational implications of the programme. The MPF has produced clinical-grade bacteriophages under controlled conditions, enabling reproducibility and scalability in therapeutic development.

“This was a pivotal phage therapy case of a very difficult-to-treat infection. What we have learnt here will allow us to provide faster and more effective phage treatments in the future. With collaborators around Australia, we are reviewing methodologies, phage production approaches, and data collection from treated patients across the country.

“There is still a long road ahead, but it is one we are determined to travel as this therapy has the potential to save hundreds of lives for patients suffering from serious and life-threatening infectious disease,” Barr said.

The VICPhage initiative is therefore positioned at the intersection of clinical care, regulatory science and biotechnology innovation. Its integrated model has enabled individual patient treatment and systematic evidence generation to inform future therapeutic frameworks. As AMR continues to compromise the effectiveness of conventional antibiotics, such programmes have begun to define a pathway towards precision antimicrobial therapy.

The findings have marked an important step in that trajectory, with the identification of immune-mediated barriers to treatment representing a critical advance in understanding how phage therapy performs in real-world clinical settings.

For further reading please visit: 10.1038/s41591-026-04301-0