HCL: two unprecedented victories against antibiotic resistance

Two HCL patients with severe osteoarticular infections were successfully treated with phages. A procedure which remains exceptional in France and very supervised but represents hope against resistant infections.

Using viruses that are harmless to humans to get rid of resistant bacteria: this is the principle of phage therapy. Born a century ago, this therapy had been abandoned in the West in favor of antibiotic therapy but it appears today as a hope in the face of antibiotic resistance. However, as bacteriophages are living organisms, their use remains highly regulated in France.

After a clinical study on burn patients – in which the Saint-Joseph Saint-Luc hospital participated and which is to be published soon – the use of phages to treat patients on a “compassionate” basis may be authorized by the Agency national medicine. The procedure remains exceptional: one patient was treated in 2015 and another in 2016. This year, two patients were treated, both in Lyon, at the reference center for complex bone and joint infections (Crioac) of the hospital of the Croix Rousse. This is the first time that phages manufactured in France, by the company Pherecydes Pharma, have been used to treat these severe infections which were unable to heal.

The first patient was infected with a bacterium pseudomonas aeruginosa resistant to several antibiotics, after receiving cement in the sacroiliac joint attacked by bone metastases. The second patient had contracted three bacteria, including staphylococcus aureus, after the fitting of a hip prosthesis. In both cases, the patients were operated on again, their wound was cleaned and it was just before closing it that the phages were injected via a syringe. These two patients then saw their scars close quickly.

But in both cases, phage therapy was therefore administered in addition to surgery and antibiotic therapy. "It is integrated into a global strategy to maximize the chances of success in these complex and very heterogeneous infections", explains Prof. Tristan Ferry, head of Crioac. “Phages are not necessarily competitors of antibiotics. They can be complementary and even help antibiotics regain their effectiveness”, underlines Guy-Charles Fanneau de la Horie, president of Pherecydes Pharma.

Partners in the Phosa project, the company and the HCL want to launch clinical studies. Pherecydes Pharma thus hopes to obtain, within 2 to 3 years, marketing authorizations for its phage-based treatments against respiratory infections, osteo-articulatory infections and diabetic ulcers.

Article written by Sylvie Montaron and published in Le Progrès