Bacteriophages, the viruses that infect and kill bacteria, were first explored as therapeutic agents in the early twentieth century, shortly after their discovery by Frederick Twort and Félix d’Hérelle. While Western medicine largely abandoned the approach after the arrival of antibiotics, parts of Eastern Europe and the former Soviet Union never stopped using it. The new review, authored by a large consortium of researchers led by Roman Pantůček and Jiří Doškař of Masaryk University in Brno, documents how the Czech lands participated in this long tradition and how that historical foundation has been systematically rebuilt and modernized since the year 2000.

The review’s authors describe a national ecosystem in which academic institutions, biotechnology companies, and university hospitals work in parallel rather than in isolation. According to their analysis, more than 30 competitively funded research projects have been launched in the Czech Republic since 2000, addressing the central technical challenges that stand between laboratory phage research and routine clinical use. These projects have tackled phage safety assessment, genomic characterization of therapeutic candidates, formulation and delivery strategies, synergy between phages and conventional antibiotics, and the difficult problem of manufacturing phage preparations under Good Manufacturing Practice, the regulatory quality standard required for medicines.

The technical depth of this national effort is considerable. Genomic characterization, for example, is now understood as a non-negotiable prerequisite for any phage intended for human use, since phage genomes can harbor toxin genes or other undesirable cargo, and whole-genome sequencing allows candidate viruses to be screened before they ever reach a patient. The Czech teams have applied these methods extensively to staphylococcal phages, an area in which Masaryk University researchers have long specialized, reflecting the country’s historical focus on Staphylococcus aureus infections and conditions such as osteomyelitis, a stubborn bone infection that is notoriously difficult to treat with antibiotics alone and where topical phage preparations such as the long-standing Czech product Stafal found early application.

Stafal itself occupies an important place in the review’s historical narrative. Developed and produced in Czechoslovakia for decades, the staphylococcal phage preparation was used in the treatment of bacterial infections and became one of the few phage products in Europe with continuous production and clinical availability across the political upheavals of the twentieth century. Its survival into the modern era gave Czech researchers and clinicians a continuity of practical experience that few other Western or Central European countries can claim, and it served as a bridge between the empirical phage medicine of the past and today’s evidence-based, molecularly characterized approaches.

Clinical translation is now advancing along two complementary tracks. The first is treatment on a named-patient basis, a compassionate framework that allows physicians to administer phage preparations to individual patients with severe, otherwise untreatable infections, often under national regulations that accommodate unlicensed medicines when no authorized alternative exists. The second track consists of formal clinical trials, which the review describes as ongoing. Moving from anecdotal case reports to controlled studies is widely regarded by the phage therapy community as the decisive step toward regulatory acceptance, and the Czech combination of clinical partners and domestic GMP-compliant production places the country in a strong position to generate the kind of standardized evidence that regulators require.

The review also emphasizes that the Czech phage effort extends well beyond human medicine. In veterinary practice, phages have been investigated as alternatives to antibiotics in livestock, where reducing antimicrobial use has become a priority both for controlling resistance and for meeting European policy targets. In agriculture, researchers have explored phage-based biocontrol of plant pathogenic bacteria, an application studied at the Czech Academy of Sciences’ plant virology institute in České Budějovice. Food safety represents a third area of application, with phages offering a way to reduce pathogenic bacteria on food products without chemical residues. Together these sectors demonstrate a breadth of phage expertise that reinforces the human medicine pipeline, since methods for phage isolation, characterization, and formulation are largely transferable across applications.

Structural biology has added a distinctive dimension to the national program. At the Central European Institute of Technology in Brno, researchers including Pavel Plevka and Tibor Füzik apply cryo-electron microscopy to determine the atomic structures of phage particles, revealing how these viruses recognize their bacterial hosts and deliver their genetic material. Such structural insight is increasingly relevant to rational phage engineering, in which viruses are modified to broaden their host range, evade bacterial defense systems, or improve their stability in pharmaceutical formulations. The presence of world-class structural biology alongside classical phage biology and industrial production is precisely the kind of interdisciplinary integration the review identifies as a national strength.

Looking forward, the authors identify several priorities that will determine whether Czech phage therapy can move from promising practice to sustainable standard of care. Sustainable access to standardized phage preparations is paramount: phage therapy is inherently individualized, because phages must be matched to the specific bacterial strain infecting each patient, and bacteria can evolve resistance to individual phages, so therapeutic preparations typically consist of carefully designed cocktails of multiple viruses. Maintaining libraries of well-characterized phages, updating them in response to evolving bacterial populations, and producing them reproducibly under GMP conditions is logistically and financially demanding in ways that conventional small-molecule antibiotics are not. The review argues that this challenge must be addressed within the rapidly evolving European regulatory framework, which is only now beginning to define how individualized biological therapies should be assessed, authorized, and reimbursed.

The broader significance of the Czech experience extends across the continent. As antimicrobial resistance is projected to cause millions of deaths annually in the coming decades, European health systems are actively searching for non-traditional antibacterial therapies, including enzybiotics, phage-derived enzymes that degrade bacterial cell walls, alongside whole-phage treatments. The review’s conclusion is that the Czech Republic has established the substantial expertise and infrastructure needed to serve as an important European contributor to this effort, offering a working model of how a long national tradition, when combined with modern genomics, structural biology, regulatory engagement, and industrial capability, can be transformed into a coherent pathway for integrating phage-based interventions into twenty-first-century healthcare.

Subject of Research: Phage therapy research, clinical practice, and development in the Czech Republic as a contribution to phage therapy in Europe

Article Title: Past and present phage therapy research and practice in the Czech Republic – contribution to phage therapy in Europe

Article References: Pantůček, R., Doškař, J., Boštík, J., Kocourková, D., Petrzik, K., Koptíková, J., Benešík, M., Plevka, P., Füzik, T., Mašlaňová, I., Botka, T., Nepeřený, J., Zeller, D., Kuntová, L., Snopková, K., Hrala, M., & Moša, M. (2026). Past and present phage therapy research and practice in the Czech Republic – contribution to phage therapy in Europe. Virology Journal. https://doi.org/10.1186/s12985-026-03296-x

Image Credits: AI Generated

DOI: 10.1186/s12985-026-03296-x

Keywords: phage therapy, bacteriophages, antimicrobial resistance, Czech Republic, Staphylococcal infections, Stafal, GMP manufacturing, clinical trials, enzybiotics, biocontrol, osteomyelitis, phage-antibiotic synergy