The Rescue That Revived Phage Therapy in America

In late November 2015, psychiatry professor Tom Patterson fell ill on a vacation in Egypt. What looked like food poisoning was the beginning of a near-fatal ordeal. A CT scan revealed a gallstone-obstructed pseudocyst in his abdomen teeming with Acinetobacter baumannii — a Gram-negative pathogen the World Health Organization would later rank among its highest-priority threats. The strain was resistant to essentially every antibiotic in the formulary. After air-medical transfers to Frankfurt and then home to the University of California San Diego, Patterson deteriorated. The pseudocyst leaked, seeding his bloodstream. By March 2016 he was septic, comatose, and on a ventilator, drifting toward death.

His wife, infectious-disease epidemiologist Steffanie Strathdee, refused to accept that nothing more could be done. Searching the literature from his bedside, she rediscovered bacteriophage therapy — the use of bacteria-killing viruses, a Soviet- and Georgian-era practice largely abandoned in the West after the antibiotic boom. She began emailing phage researchers worldwide, asking the audacious question of whether phages could be given intravenously to treat a systemic infection, something almost never attempted in modern Western medicine.

An extraordinary collaboration assembled within days. Patterson's treating physician, Robert 'Chip' Schooley, coordinated the clinical effort. A laboratory at Texas A&M University led by Ry Young, the U.S. Navy's biological defense research lab (NMRC) in Maryland, and the San Diego biotech AmpliPhi all raced to hunt down phages active against Patterson's exact isolate. Teams screened environmental samples — sewage, soil, animal waste — searching for viruses that recognized his strain. The FDA granted emergency expanded-access (compassionate use) authorization.

On March 15, 2016, clinicians began infusing a personalized cocktail of phages directly into the abscess cavities through catheters. Two days later, after additional purification to strip bacterial endotoxin from the preparations, a second cocktail was administered intravenously into Patterson's bloodstream — among the first such deliberate systemic uses of phage in the modern United States. The risk was real: injecting crude viral preparations could have triggered a catastrophic immune reaction.

The turning point came swiftly. Within days of the intravenous treatment, Patterson awoke from his coma, lifted his head, and recognized his daughter. His clinical trajectory reversed. The A. baumannii — which had developed some phage resistance during treatment, prompting the team to swap in additional phages — was ultimately brought under control, aided by the resumption of an antibiotic (minocycline) to which the bacteria had become re-sensitized. After months in critical care, Patterson recovered and went home.

The case was published in Antimicrobial Agents and Chemotherapy in 2017 by Schooley, Strathdee, and colleagues. It was the first documented use in the United States of intravenous personalized phage cocktails to treat a systemic, multidrug-resistant bacterial infection — and it became a catalytic event. UC San Diego went on to establish IPATH (the Center for Innovative Phage Applications and Therapeutics), the first dedicated phage-therapy center in North America, in 2018. Strathdee co-authored a bestselling memoir, The Perfect Predator, and became an international advocate for the field.

The Patterson case did not prove that phage therapy works in the rigorous sense a randomized trial demands — it was a single patient receiving multiple simultaneous interventions. But it reopened a door that had been shut for half a century. It demonstrated that a personalized phage cocktail could be sourced, purified, and administered intravenously within days, and that regulators would permit it for the dying. In an era of accelerating antimicrobial resistance, one man's recovery reminded medicine of a forgotten weapon.