CASE STUDY
Treating our first patient
In 2019, 7-year-old Dhanvi was in a car accident. Her leg was about to be amputated due to an infection that antibiotics failed to cure.
Dhanvi’s paediatrician, Dr. Ameneh Khatami, wanted to try an experimental treatment called phage therapy.
“Three months of IV antibiotics had failed to stop the progress of infection and no other medical or surgical options were available.”
Dr. Ameneh Khatami
Source: Cysticfibrosis.org
Prof. Jon Iredell
It wasn’t the first time phages had been used in Australia. Dr. Khatami’s colleague, Prof. Jon Iredell, had used phages to treat adults.
However no one had phages ready for Dhanvi.
Not all phages are equal. Each phage has a set of bacteria it will kill, and others it will leave alone. Some phages are efficient killers, others aren't.
Harnessing them means gathering as many as you can, assessing strengths and weaknesses, and putting the right one into the fight.
This takes time and effort.
Getting help from phage researchers globally
To find phages for Dhanvi, the team put out a call to phage researchers globally.
A dozen labs volunteered to help, from all over the world. Samples of the bacteria from Dhanvi’s leg were sent to them. Each lab tested whether any of the phages in their collections could kill Dhanvi’s bacteria.
The labs that responded to Dhanvi’s phage alert spanned 12 countries.
Dhanvi’s good fortune
A week after receiving Dhanvi’s bacteria, a research lab in Israel emailed back. They had found a phage that could kill her bacteria. Luckily, the lab had already studied that phage, and knew it was a good one. It didn’t have any harmful-looking genes, meaning it should be safe to use.
What’s more, the lab had previously sent this phage to a US phage company, Adaptive Phage Therapeutics, for another patient. This meant it was already purified and ready for Dhanvi.
Adaptive Phage Therapeutics
Source: Business Wire
Dhanvi gets phage therapy and avoids amputation
Six weeks after the phage search began, Dhanvi’s phage arrived. Her doctor added it to her IV bag. She got phages each day for several weeks, and she was closely monitored.
Within two weeks, her infection started healing. Soon after, she was able to walk.
“After seven weeks of phage therapy, Dhanvi recorded pain-free weight bearing […] for the first time since the initial injury.”
Source: ABC News
How do we treat thousands more Dhanvis?
Dhanvi was lucky: the right phage had been found and purified before she needed it, and she happened to find doctors with the right connections. But there aren’t many phages sitting ready like this. And few in Australia know how to access and use the ones that are.
How do we fix this?
We need to find, certify, and purify phages in advance
We need fast ways of finding the right phage for any patient
We need phage therapy treatment and monitoring instructions
We need to support pharmacists, nurses and doctors through the process
We need to compile evidence of outcomes
We need to get phage therapy approved as a medicine in Australia
Dr. Ruby CY Lin