Introducing the AusHealth Phage Therapy Centre: taking the fight to antimicrobial resistance

Antimicrobial resistance is predicted to cause 10 million deaths by 2050. Could phage therapy be the solution?

This week saw the official launch of the AusHealth Phage Therapy Centre. It’s home to a team of researchers who are taking up arms against one of the greatest challenges modern medicine faces – the rise of antimicrobial resistance.

Located in Adelaide’s Basil Hetzel Institute for Translational Health Research, the centre is directed by the leadership of the Department of Ear Nose and Throat diseases: Professors PJ Wormald, Alkis Psaltis and Sarah Vreugde.

They oversee multiple research projects using phages (naturally occurring viruses that target bacteria) to destroy drug-resistant bacteria. Any type of infection can be targeted by phage therapy but the team focuses mainly on infections of the airways and skin.

Phage therapy has been around since the 1920s – the Eliava Institute in Georgia has used it to treat infections for more than 100 years. But with the emergence of ‘superbugs’ that are increasingly difficult to treat due to antibiotic resistance, science is looking to unlock the power of phage.

Antimicrobial resistance has risen through our misuse and overuse of antibiotics and the fact bacteria are constantly evolving to outsmart our drugs. “There are an increasing number of infections that we can no longer treat with antibiotics,” says Professor Sarah Vreugde, Director of Research at the AusHealth Phage Therapy Centre. “And phage therapy is an exciting potential solution. It’s a natural biological entity and, from more than 2000 cases treated worldwide, it appears to be safe and very effective.”

Phage therapy targets only the bacteria causing the disease and leaves ‘good’ bacteria in the microbiome unharmed. It is also quickly translatable: the Centre’s team isolated their first phages from local wastewater in 2021 and are already treating patients.

“That timeframe is quite remarkable when you compare it to the development of a new antibiotic, which may take up to ten years or more in clinical development,” says Sarah.

At the end of 2024, the team delivered their first personalised phage treatment to a patient with chronic infection of the lung and sinuses. The results were very promising.

“We administered phage therapy twice daily by nebulisation [a form of inhalation therapy] for a month, and we saw a dramatic reduction in their infection, even after the first days of treatment. “

“Within five days of phage treatment, the bacterial infection was almost completely eradicated in a patient who had failed previous standard antibiotic therapy.  The patient’s response seems sustained as they are still feeling symptom-free three months after treatment.”

From this case, the team learned that using phage in combination with antibiotics gets a much better result in killing bacteria than using phage or antibiotics alone.

The Centre has come a long way very quickly.

Originally trained as a medical doctor and ENT surgeon, Sarah was recruited to the Department of Otolaryngology, Head and Neck Surgery by Professor PJ Wormald. As the clinician leading the department, Professor Wormald was already interested in phage therapy and what it could do for patients.

“Between 2011 and 2021 we did a lot of pre-clinical studies and a clinical trial to show that phage is safe and effective,” says Sarah.

After the Phage Therapy Centre was established in 2021, it rapidly expanded from two part-time researchers to a team of around 10 scientists.

They set about building a ‘library’ of phages that can be used in therapy. Phages are everywhere and are the most abundant biological entity on earth, outnumbering all other organisms including bacteria. “Not all phages can be used in therapy so a lot of research has to be done to isolate the ones that are useful for us. Now that we have a collection of such phages, we can manufacture infection-specific treatments within one or two weeks,” Sarah says.

As new drug-resistant infections come to light, so new phages have to be developed and added to the library. New phages can be isolated from wastewater or other environmental sources, purified, verified for safety and then manufactured – the whole process can take up to three months.

The Centre currently has patients waiting for phage treatment to be developed by the team – which raises the question, what is the future of phage therapy in Australia?

“The question is, are we going to focus on ‘last resort’ patients where antibiotics are not working at all to treat their infection?” says Sarah. “Or are we going to eventually use phage therapy for less severe infections?”

“That will require time and a lot of research to answer. But I have no doubt that phage therapy is going to have a place in treating patients.”

Medical research charity AusHealth has been supporting the Phage Therapy Centre since 2021, a contribution that is now recognised in the new name.

According to Belinda Wade, AusHealth Operations Manager, “We are thrilled to officially open the AusHealth Phage Therapy Centre.

“AusHealth has committed close to $640,000 over two years to investigate the use of phage in a diverse range of indications. This discovery and development platform is fundamental to building a ‘bench to bedside’ capability in Australia and realising the benefits of phage-based therapies.”