Phage therapy: An international survey of attitudes and experiences amongst clinicians.

Phage therapy is a promising tool to combat the global threat of antimicrobial resistance. Clinicians, as part of interdisciplinary teams, play an integral role in identifying patients for therapy, delivering phages, and monitoring treatment outcomes and safety. As such, in the context of rapidly evolving regulatory landscapes, clinician insight is crucial for advancement of phage therapy. In this study, we describe the first published international anonymized survey aimed at identifying attitudes and experiences of clinicians and healthcare professionals towards phage therapy. We distributed the survey to participants in the Global Clinical Phage Rounds, a network of >300 phage clinicians, health professionals, and scientists, from October 15, 2024 - January 30, 2025. Thirty respondents representing North America, Europe, Oceania, Africa, and Asia completed the survey (response rate 9.6%). The majority of respondents were very well-informed about phage therapy and 93% would consider enrolling their patients in phage therapy randomized controlled trials. Respondents identified Pseudomonas aeruginosa, Klebsiella species, and Staphylococcus aureus as priority organisms and bone/joint, respiratory, and urinary tract infections as priority syndromes. Respondents had concerns about clinical use evidence, regulatory barriers, and accessing phage. Twenty respondents reported experience with phage therapy, so answered additional questions. These respondents acquired phages from sources like phage banks, industry, and importation from other countries. Respondents delivered phage therapy primarily in single-use cases via parenteral/intravenous, topical, or inhalation routes. Experienced respondents endorsed combinations of monitoring before, during, and/or after phage therapy. These results serve as a guiding initiative to improve phage therapy integration in healthcare.