A Spanish-led treatment cleared a drug-resistant infection that threatened to cost a war-injured patient his limb. Doctors had considered amputation to stop the bacteria from reaching his bloodstream. Instead, they used a personalized bacteriophage with colistin. The infection cleared, and the wound began to heal.
The patient is a 52-year-old man who suffered severe injuries during a conflict in 2022. He underwent several operations. The wound then developed a persistent infection caused by Klebsiella pneumoniae, a bacterium resistant to several medicines. Standard antibiotics failed to eliminate it, leaving the medical team with few options.
Doctors then contacted Pilar Domingo and her team at the Environmental and Biomedical Virology Group of the Institute for Integrative Systems Biology. The institute is a joint centre of the Spanish National Research Council and the University of Valencia. Researchers selected and characterised a bacteriophage that could attack the strain found in the patient, then produced it for treatment.
Doctors gave the virus intravenously and directly at the affected site. Colistin was administered alongside it under compassionate-use authorisation from the Spanish Agency for Medicines and Medical Devices. The response was rapid: the bacterium was no longer detected in wound samples by the eighth day.
Later tests also remained negative.
During follow-up, the wound gradually closed, and the patient recovered some movement in his elbow. The improvement continued without reported adverse effects linked to the treatment. The work was carried out with the General Defence Hospital in Zaragoza and published in the International Journal of Infectious Diseases, information from the CSIC.
The case differs from the road incident described in an earlier report. Here, the danger did not end when the initial trauma was treated. It remained inside a deep, surgically damaged wound. Resistant bacteria could still threaten tissue or bone, including around implants, and force further operations.
That is why bacteriophages are drawing attention as a possible partner to antibiotics and surgery. These viruses target specific bacteria rather than many microbes at once, so researchers can match a treatment to the strain found in an individual patient. That precision also limits how widely one preparation can be used. Researchers must first select and produce it in the laboratory.
German medical publications, including Apotheken Umschau and Ärzte Zeitung, describe phage therapy as an option when antibiotics fail. They say preparations may be given intravenously or through the nose. They can also be delivered as a sterile hydrogel for wounds or by inhalation.
Armed conflicts can raise the risk of persistent infections. Medical access may be restricted, while scarce supplies can delay treatment. Deep wounds are especially difficult when they involve bones. Prostheses and implants can complicate them further. Klebsiella pneumoniae remains a difficult pathogen, and current research continues to focus on carbapenem resistance and hypervirulent strains.
In this case, tests no longer detected the bacterium, and the wound began to heal, allowing doctors to avoid amputation.
The report does not show that phage therapy can replace antibiotics or surgery. The 2026 European recommendation also says that controlled clinical evidence remains insufficient. It calls for treatment to be organised by a multidisciplinary team, with clinicians coordinating input from microbiologists and phage specialists.
Clinical development is still under way. More studies are needed to measure the treatment's effectiveness and set protocols for routine care. The case shows its possible value in a narrower situation: when a multiresistant infection leaves standard treatment unable to save a limb, a bacteriophage matched in the laboratory to the patient's strain can offer another route. That is a reason to develop personalized anti-infection treatments before surgery becomes the only remaining option.
