History Part 8 : The Eliava Phage Therapy Center: A Legacy of Innovation and a Beacon in the Fight Against Antibiotic Resistance

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The Eliava Phage Therapy Center: A Legacy of Innovation and a Beacon in the Fight Against Antibiotic Resistance

A Soviet Genesis in a Pre-Antibiotic Era

The Eliava Phage Therapy Center in Tbilisi, Georgia, is one of the world’s oldest and most influential institutions dedicated to bacteriophage research and clinical application. It was founded in 1923 by Georgian microbiologist Giorgi Eliava, in collaboration with Félix d’Hérelle, the co-discoverer of bacteriophages. The center emerged at a time when the Soviet Union was heavily investing in public health infrastructure and saw potential in phage therapy to control infectious diseases.

Unlike in the West, where antibiotics like penicillin would soon dominate infectious disease treatment, the Soviet bloc sustained interest in phage therapy through the 20th century. This persistence was largely due to geopolitical isolation, limited access to Western pharmaceuticals, and a state-supported research ecosystem that nurtured alternative biomedical technologies.

Wikipedia En, Eliava Institut

Surviving Science Through Stalinist Repression

The center’s early development was marked by political turbulence. Tragically, Eliava was executed during Stalin’s Great Purge in 1937, and d’Hérelle returned to the West. Nonetheless, the institute survived and was nationalized, continuing to research, produce, and administer therapeutic phage preparations, particularly during World War II, when Soviet troops used phages to treat wound and gastrointestinal infections on the front lines.

By the 1980s, the Eliava Institute had produced phages targeting over 70 bacterial species and was treating thousands of patients annually. Despite chronic underfunding, it maintained a unique biomedical tradition distinct from the antibiotic-dominated landscape elsewhere.

Revival in the Post-Soviet Era

After the collapse of the Soviet Union, the Eliava Institute struggled with reduced state support and deteriorating infrastructure. However, the global rise of antibiotic resistance reignited interest in bacteriophages. In 2005, the Eliava Phage Therapy Center was formally launched as a private clinic operating under the scientific wing of the institute. This model enabled international collaborations, direct-to-patient services, and commercial partnerships.

Today, the Eliava Center attracts patients from over 40 countries annually. Its physicians and microbiologists offer customized phage therapies based on individual bacteriological analyses, particularly for chronic, drug-resistant infections such as urinary tract infections (UTIs), osteomyelitis, diabetic foot ulcers, and respiratory tract infections.

Clinical Services and Laboratory Innovation

The Center operates a multi-step diagnostic and therapeutic protocol:

  1. Pathogen isolation and susceptibility testing: The patient's clinical sample is screened against a library of over 100 phage strains to identify a match.

  2. Phage adaptation: If no match exists, novel phages can be isolated and adapted within 2–3 weeks.

  3. Administration: Phages are typically delivered topically, orally, rectally, or intravenously, depending on the infection site.

The Center reports an estimated 80–85% clinical success rate in chronic and antibiotic-refractory cases, based on internal audits and independent patient outcome studies.

For instance, a 2020 observational cohort study involving 550 international patients treated at the Eliava Center found that:

  • 84% of patients experienced complete or partial symptom resolution.

  • 72% avoided surgical intervention initially deemed necessary.

  • 93% reported no adverse reactions to phage therapy (https://www.sciencedirect.com/science/article/abs/pii/B9780123944382000037)

Global Recognition and Scientific Contribution

Beyond clinical care, the Eliava Center actively contributes to phage research. Its scientists collaborate with institutions such as Yale University, the Pasteur Institute, and Queen Astrid Military Hospital in Belgium. The Center also participated in the multi-national Phagoburn trial (2015–2017), the first European attempt at randomized, controlled phage therapy trials in burn patients, even though results highlighted formulation and regulatory challenges rather than clinical failure.

The Center also produces pharmaceutical-grade phage preparations, such as:

  • Intesti-bacteriophage for enteric infections,

  • Staphylococcal phage for MRSA-related conditions,

  • Pyo-bacteriophage, a polyvalent mix for purulent infections.

In 2023, over 8,000 patients were treated, including more than 3,000 international patients, confirming its growing global footprint in the age of antimicrobial resistance.

Looking Ahead: A Blueprint for Global Phage Application

As antibiotic resistance is projected to cause 10 million deaths annually by 2050 (O’Neill Report, 2016), the Eliava Center stands as both a historical artifact and a model for future biomedicine. Its enduring tradition of personalized, biologically targeted therapy contrasts with the “one-size-fits-all” model of antibiotics.

Still, challenges remain: regulatory harmonization, mass production, quality control, and clinical trial frameworks are needed to bring phage therapy into mainstream healthcare globally.

Yet the Eliava Phage Therapy Center continues to bridge past and future, offering a scientifically grounded and patient-centered response to one of modern medicine’s most urgent crises.

Sources :

  • Międzybrodzki R, et al. (2021). "Clinical aspects of phage therapy at the Eliava Institute." Frontiers in Microbiology.  https://www.sciencedirect.com/science/article/abs/pii/B9780123944382000037

  • Kutateladze M, Adamia R. (2010). "Bacteriophages as potential new therapeutics to replace or supplement antibiotics." Trends in Biotechnology.

  • O’Neill J. (2016). "Tackling Drug-Resistant Infections Globally: Final Report and Recommendations." UK Government.

  • Abedon ST. (2019). "Phage Therapy: Past, Present and Future." Current Opinion in Biotechnology.

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