Natural predators of viruses offer a potential alternative to antibiotics


Professor Jon Iredell

Professor Jon Iredell from Faculty of Medicine and Health and his team at Phages Australia, exploit the natural predatory viruses of bacteria, called bacteriophages or phages that are found everywhere in nature. In fact, they are the most abundant and diverse form of life on Earth.

By 2050, antimicrobial resistance is expected to become the first cause deaths worldwide, taking about 10 million lives per year and exceeding deaths from cancer and cardiovascular disease.

The World Health Organization warned that the failure of antibiotics due to antimicrobial resistance could lead to the end of modern medicine, as common infections become incurable and surgeries carry an increased risk of infection, sepsis and death.

According to Professor Iredell, the Asia-Pacific region will be particularly affected by antimicrobial resistance, with the estimated annual impact on the global economy by 2050 expected to be between $100 billion and $120 billion.

Phagotherapy was first used a century ago and continues to be a popular treatment option for bacterial infection in Eastern Europe, but it fell out of favor in the West after the discovery of antibiotics.

“The phages effectively attack and fight and destroy multidrug-resistant bacteria, making them a suitable alternative to antibiotics for the treatment of bacterial infections,” Professor Iredell said.

“With careful preparation to remove impurities, phages are harmless to humans, easy to produce, and completely effective against antibiotic-resistant bacterial strains – providing a last defense against otherwise incurable infections.”

Currently, Phages Australia can only provide phage therapy in compassionate cases. Next successful studies about severe sepsis at Westmead Hospital, infection specialist at Westmead Children’s Hospital and deputy director of Phage Australia, Dr Ameneh Khatami, said she recently helped doctors successfully treat a life-threatening lung infection and saving a seven year old girl’s leg facing amputation due to ongoing antimicrobial resistant infection.

The team now aims to make the therapy widely available throughout the Australian healthcare system by establishing it in the Australian (and international) pharmacopoeia through a national industrial ecosystem of genomics and informatics, diagnostics, clinical trials, manufacturing and international biobanks.

The researchers have already assembled a management team, started phage production, enrolled their first patients in clinical trials, and are developing infrastructure for implementation and analysis.

Over the next five years, they aim to provide precision phage therapy to Australians and define its role for prescribers and patients in the Asia-Pacific region. They will also work with regulators to find a place for phage therapy in the National Pharmacopoeia – established standards for pharmaceutical substances and medicinal products that help control the quality of medicines in Australia. At this point, the therapy is not approved by the TGA.

One of the great advantages of phage therapy is its ability to precisely target strains of bacteria. Unlike antibiotics, each phage is very specific in the specific bacteria it targets. This means that, unlike broad-spectrum antibiotics, phage therapy does not impact healthy bacteria in the human body, making it a suitable third approach for infectious disease control (after vaccination and antibiotics).

According to the Deputy Director of Phage Australia, Associate Professor Ruby Lin this specificity is what makes phage therapy so important for the future of public health.

“Phage can be a powerful treatment weapon for clinicians because it is so targeted. You can specify how much filler you want to release at the site of infection, dictating exactly how many milligrams or nanograms of drug you want to deliver,” she said.

Associate Professor Lin believes the development of phage therapy also has the potential to prepare the Australian healthcare system for future infectious disease outbreaks.

“When COVID-19 arrived, we weren’t prepared for infectious diseases. Medical countermeasure is very important, and phage therapy is part of that big picture of pandemic and antimicrobial resistance surveillance and preparedness,” she said.

“We still need antibiotics, but phage therapy can offer another solution. Ideally, we would like to add phage therapy to the Australian Pharmacopoeia. There is a worldwide movement towards phage therapy as it is the only way to deal with antimicrobial resistance.

Professor Iredell and his team in Sydney are researching genomic technologies that will help turn the phage into a better weapon to fight infection.

“We pioneered phage therapy for humans in Australia in 2007 and are still the only site in Australia to have treated adults and children with phage therapy,” he said.

“The momentum we have created is very strong, but we cannot maintain our leading position without financial support, it is very urgent now.”

Professor Iredell hopes Phage Australia will receive the funding needed to provide the first sustainable source of phage therapy in the Southern Hemisphere.


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