COMMENTARY The Phage Therapy Paradigm: Prêt-à-Porter or Sur-mesure? Jean-Paul Pirnay & Daniel De Vos & Gilbert Verbeken & Maia Merabishvili & Nina Chanishvili & Mario Vaneechoutte & Martin Zizi & Geert Laire & Rob Lavigne & Isabelle Huys & Guy Van den Mooter & Angus Buckling & Laurent Debarbieux & Flavie Pouillot & Joana Azeredo & Elisabeth Kutter & Alain Dublanchet & Andrzej Górski & Revaz Adamia Received: 22 July 2010 / Accepted: 27 October 2010 / Published online: 10 November 2010 # Springer Science+Business Media, LLC 2010 KEY WORDS antibiotic resistance . bacterial infection . bacteriophages . drugs . phage therapy The present opinion is the result of discussions on the future of phage therapy (personalized or large-scale uniform therapy?) during the first International Congress on Viruses of Microbes, held at the Institut Pasteur in Paris on June 21–25, 2010. Antibiotics are becoming ineffective as important bacterial pathogens evolve to outsmart them. Yet the antibiotic pipeline is running dry with only a few new antibacterial drugs expected to make it to the market in the foreseeable future. Bacteria that are resistant to all available antibacterial drugs, so-called superbugs, are emerging worldwide. Evolutionary ecology might inform practical attempts to bring these pathogens under stronger human control (1). In this context, various laboratories worldwide and a handful of small pharmaceutical companies are turning to (bacterio)phages (2). Phages are natural viruses that specifically infect bacteria. They are (among) the most abundant and ubiquitous lifelike entities on Earth and coevolve with their hosts, the bacteria. Lytic phages bind to receptors on the bacterial cell surface, inject their genetic material, use the bacterium’s reproductive machinery to replicate and subsequently destroy (lyse) the bacterium, irrespective of its resistance to antibiotics, releasing the newly formed phages to seek out new hosts. In 1919, d’Herelle used phages to treat dysentery in Paris, in what was probably the first attempt to use phages therapeutically. d’Herelle eventually developed a commercial laboratory in Paris that produced phage preparations against J.-P. Pirnay : D. De Vos : G. Verbeken : M. Merabishvili Laboratory for Molecular and Cellular Technology Burn Wound Centre, Queen Astrid Military Hospital 1120 Brussels, Belgium M. Merabishvili : N. Chanishvili : R. Adamia Eliava Institute of Bacteriophage Microbiology and Virology 380060 Tbilisi, Georgia M. Merabishvili : M. Vaneechoutte Laboratory of Bacteriology Research, Faculty of Medicine Ghent University 9000 Ghent, Belgium M. Zizi Department of Physiology Free University Brussels 1090 Brussels, Belgium M. Zizi Section Health of the Division Well-Being (Belgian Defence Staff) Queen Astrid Military Hospital 1120 Brussels, Belgium G. Laire Office of the Surgeon General, Belgian Defence 1140 Evere, Belgium R. Lavigne Laboratory of Gene Technology, Katholieke Universiteit Leuven 3001 Leuven, Belgium I. Huys Faculty of Law, Centre for Intellectual Rights Catholic University of Leuven 3000 Leuven, Belgium G. Van den Mooter (*) Laboratory of Pharmacotechnology and Biopharmacy Catholic University of Leuven Herestraat 49 3000 Leuven, Belgium e-mail: guy.vandenmooter@pharm.kuleuven.be Pharm Res (2011) 28:934–937 DOI 10.1007/s11095-010-0313-5