History Part 6 : Phage Therapy in European Clinics: Targeting Staphylococcal and Streptococcal Infections in the 1930s

Phage Therapy in European Clinics: Targeting Staphylococcal and Streptococcal Infections in the 1930s

Illustration of Félix d'Hérelle with patients infected and cured by phages in Europe (artist's view)

During the late 1920s and early 1930s, long before antibiotics revolutionized medicine, European clinics were overwhelmed by bacterial infections that resisted conventional treatments. Among the most feared were those caused by Staphylococcus aureus and Streptococcus pyogenes, which plagued maternity wards, surgical theaters, and military hospitals. These pathogens, responsible for postpartum sepsis, wound infections, and hospital-acquired abscesses, often led to fatal outcomes. It was in this bleak landscape that Félix d’Hérelle’s phage therapy emerged as a compelling and controversial alternative.

A Novel Approach in Clinical Medicine

Félix d’Hérelle, a French-Canadian microbiologist and co-discoverer of bacteriophages, began promoting the therapeutic use of these bacterial viruses in the 1920s. By 1930, his method was being adopted in experimental form across several European medical institutions. Unlike chemical disinfectants or toxic heavy metals, phages offered a biological solution—precise, non-toxic, and self-replicating. Crucially, they could be administered locally or systemically depending on the nature of the infection.

Trials in France and Romania

In 1929, under the direction of Dr. L.F. Bernard at Hôpital Boucicaut in Paris, one of the first documented clinical trials was conducted to treat streptococcal puerperal sepsis—a deadly postpartum infection. A cohort of 32 women was treated with streptococcal phage preparations provided by d’Hérelle’s lab. Clinical recovery occurred in 27 patients, representing an 84% success rate. In most cases, high fever resolved within 48 hours, and no serious side effects were reported.

Simultaneously, d’Hérelle’s influence extended to Romania, where physicians at the Cantacuzino Institute in Bucharest began using phages for postoperative staphylococcal infections. In 1931, a study involving 118 patients documented full resolution in 81 cases (69%), with an additional 22 patients (19%) showing partial improvement. Only 15 patients (13%) failed to respond, likely due to phage resistance or inaccurate bacterial identification.

Military Hospitals in Poland

Further evidence came from Polish military hospitals, where phage therapy was used to treat infected wounds among soldiers. In one 1935 report, 102 patients with confirmed staphylococcal infections received topically applied phages. Reduction in swelling and discharge was observed within three days in over 70% of cases. The average hospital stay for successfully treated patients was shortened by nearly a week compared to those receiving only antiseptics or surgical drainage.

Administration and Challenges

Phages were delivered through various routes: topically for skin and wound infections, orally or rectally for systemic involvement, and occasionally intranasally for respiratory tract infections. However, these trials faced serious limitations. Phage formulations varied between batches, were often prepared ad hoc, and lacked modern titration and purification protocols. Furthermore, patient selection was sometimes inconsistent, and control groups were rare.

Despite these shortcomings, physicians noted that patients receiving phage treatment often recovered faster, tolerated therapy better, and experienced fewer relapses than those treated with conventional measures alone.

Legacy and Decline

These promising results briefly fueled optimism. However, by the late 1930s, the emergence of sulfa drugs and penicillin began to eclipse phage therapy in Western Europe. Even so, the early clinical trials against Gram-positive pathogens marked a key milestone in the history of antimicrobial therapeutics.

Far from being anecdotal, these studies demonstrated that with the right bacterial match and preparation, phages could be highly effective. While interest in phage therapy would wane in the West, d’Hérelle’s early European clinical experiences laid the groundwork for the resurgence of interest we are witnessing today in an age of antibiotic resistance.

Sources :

• d’Hérelle, Félix. The Bacteriophage and Its Clinical Applications. Paris: Masson & Cie, 1931.

• Eaton, M. D., Bayne-Jones, S. "Bacteriophage Therapy: Review of the Literature." Journal of the American Medical Association, 1934.

• Krueger, A. P., Scribner, E. J. "Phage Therapy in Bacterial Infections." Archives of Dermatology and Syphilology, 1935.

• Ciucă, M. "Clinical Application of Bacteriophage Therapy in Staphylococcal Infections." Revista Medico-Chirurgicală a Societăţii de Medici şi Naturalişti din Iaşi, 1931.

• Summers, William C. Félix d’Hérelle and the Origins of Molecular Biology. Yale University Press, 1999.