Viruses against bacteria: EU funds phage therapy with €15 million
Bacteria are becoming increasingly resistant to antibiotics. One alternative is treatment with viruses that exclusively infect bacteria, known as phages. A research project funded by the European Union and led by Universitätsmedizin Frankfurt is the first to investigate, within the framework of a randomized clinical trial, the combination of phage therapy and restoration of the gut microbiome to prevent recurrent urinary tract infections.
Recurrent urinary tract infections (UTIs) are among the most common bacterial infections worldwide and are becoming increasingly difficult to treat due to rising antibiotic resistance. The German Center for Infection Research (DZIF) has joined REPhRAME, an international research consortium pursuing a new approach to limit the use of antibiotics and stop the recurrence of infections. The REPhRAME project has been awarded €15 million through the European research and innovation program Horizon Europe.
A new strategy to break the cycle of infection and antibiotic use
For the first time, a two-step therapeutic approach will be assessed in a randomised clinical trial. First, phages—viruses that specifically kill bacteria—will be used to combat the pathogens. This will be followed by restoration of the intestinal microbiome to prevent recurrent infections. The project began in June 2026 and is planned to run for five years.
Each year, more than 400 million people worldwide develop a urinary tract infection, and in 30 to 50 percent of cases the infection recurs. Since standard antibiotic treatment increases the risk of resistance, many patients find themselves trapped in a cycle of infection, antibiotic treatment, and reinfection, with no lasting solution.
REPhRAME relies on phages because, unlike antibiotics, they act with a high degree of specificity: they attack only the target bacteria while leaving much of the natural microbiota unharmed.
The first treatment step uses SNIPR001, a CRISPR-armed phage cocktail that specifically targets the most common causes of urinary tract infections—certain strains of the intestinal bacterium Escherichia coli—while reducing the likelihood of new resistance emerging.
The second step focuses on restoring the gut microbiome. INTESTIFIX 001, a product of the Cologne Microbiota Bank, transfers stool bacteria from healthy donors to help re-establish the natural balance of the intestinal microbiota. The goal is to provide long-term protection against recurrent infections.
Clinical trial aims to pave the way for phage therapy in Europe
At the heart of the project is a multicenter clinical trial across Europe that will systematically evaluate the safety and effectiveness of the new treatment. Three approaches will be compared: phage therapy alone, phage therapy combined with antibiotics, and phage therapy followed by microbiome restoration.
“Recurrent urinary tract infections place a substantial burden on patients and healthcare systems, yet existing treatment options are simply insufficient for many affected individuals,” says Prof. Dr. Maria J.G.T. Vehreschild, Head of Infectious Diseases at Universitätsmedizin Frankfurt and overall coordinator of the project. “REPhRAME aims to transform phage therapy from a promising research concept into a clinically validated treatment option—with robust data on safety, efficacy, and implementation. In doing so, we hope to lay the foundation for integrating phage therapy into routine medical practice across Europe,” adds Vehreschild, who is also a scientist in the DZIF and deputy coordinator of the DZIF research area Healthcare-Associated Infections.
Led by Universitätsmedizin Frankfurt, the consortium brings together 16 partners from academia, clinical research, and industry across eight European countries. Together, they combine expertise in infectious diseases, clinical trials, phage therapy, microbiome research, microbiology, bioinformatics, regulatory science, drug development, and patient-centered research.
The partners include:
- SNIPR Biome (Denmark)
- Fraunhofer-Gesellschaft (Germany)
- German Center for Infection Research (Germany)
- Hannover Medical School (Germany)
- LINQ management GmbH (Germany)
- University Hospital Cologne (Germany)
- HUN-REN Biological Research Centre (Hungary)
- Riga Stradiņš University (Latvia)
- Leiden University Medical Center (Netherlands)
- Jafral (Slovenia)
- Swiss Institute of Bioinformatics (Switzerland)
- University of Bern (Switzerland)
- University of Zurich (Switzerland)
- University of Leicester (United Kingdom)
- University of Reading (United Kingdom)
About REPhRAME
REPhRAME stands for “Recurrent Urinary Tract Infection: Efficacy and Safety of Phage Therapy and Microbiota Transfer”. The project is funded by Horizon Europe. It has the potential to significantly reduce antibiotic use, lower the number of recurrent infections, and sustainably improve the quality of life of many patients. At the same time, REPhRAME will establish the scientific and regulatory foundations needed to bring phage-based therapies more broadly into clinical practice in the future.
Disclaimer
Funded by the European Union (EU). Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the EU or European Health and Digital Executive Agency (HADEA). Neither the EU nor the granting authority can be held responsible for them.
