Phage therapy protocol in Georgia: the full process, step by step
The essentials in 30 seconds
Phage therapy treatment at the Eliava Institute in Tbilisi follows six steps: a free remote review of your medical file, a clinical consultation on arrival, laboratory tests (culture, then phagogram), preparation of a phage solution matched to your strain, ten to fourteen days of active treatment on site, then one to two months of consolidation at home. Plan for two to three weeks in Georgia and about two months of treatment in total. Diagnosis, prescription and care are the responsibility of the Eliava Institute doctors; Se soigner en Géorgie handles translation, coordination and logistics.
The six steps at a glance
| Step | Where | Duration | Who is involved |
|---|---|---|---|
| 1. Review of your medical file | Remotely, from home | 5 working days | Eliava Institute doctors, based on your translated file |
| 2. Arrival consultation | Eliava Clinic, Tbilisi | Day 1 | The doctor specialising in your condition |
| 3. Culture and phagogram | Eliava laboratory | 3 to 5 days | The microbiologists |
| 4. Preparation matched to your strain | Eliava laboratory | 5 to 10 days if needed | The microbiologists |
| 5. Active treatment | Eliava Clinic, Tbilisi | 10 to 14 days | Your treating doctor and the care team |
| 6. Consolidation and follow-up | At home | 1 to 2 months | You, in remote contact with the medical team |
Step 1: review of your medical file, before any travel
This opinion is free, and it may be negative: if your infection is not suitable for phage therapy, you will know before spending anything. It is the most useful filter in the whole process. To find out whether your situation falls within the scope of treatment, see the page what phage therapy treats, then submit your file through the medical file review.
One point matters more than anything at this stage: the bacterium responsible must have been identified, or at least be identifiable from a sample. Without an identified bacterium, there is no phagogram, and therefore no targeted treatment.
Step 2: arrival in Tbilisi and the first clinical consultation
The initial clinical examination. You meet the doctor specialising in your condition: a urologist for urinary tract infections, a pulmonologist for lung infections and cystic fibrosis, an orthopaedic surgeon for osteitis and prosthetic joint infections, an ENT specialist for chronic sinusitis.
Review of your tests. The doctor studies your recent imaging — X-rays, CT scans, MRI — to pinpoint the site of infection and understand the antibiotic resistance mechanism involved.
Immediate sampling. To work on fresh biological material, a sample is taken directly from the site of infection — pus, urine, skin swab, sputum — and sent straight to the laboratory.
Step 3: the laboratory, culture and phagogram
This is the scientific core of the treatment, and what sets Georgian phage therapy apart from simply taking a standard product. The microbiology laboratory processes your sample in four stages.
1. Culture and identification
The sampled bacterium is isolated and cultured to confirm its exact identity and detect any co-infections. Chronic bacteria often organise themselves into a biofilm, a protective matrix that explains why antibiotics fail where phages manage to penetrate.
2. The phagogram
The phagogram is to phages what the antibiogram is to antibiotics: the microbiologist brings your strain into contact with different bacteriophage collections and observes which ones manage to lyse it, that is, destroy it. The test identifies the most virulent phage combination against your specific bacterium, not against its species in general. A dedicated article explains in detail how the phagogram works.
Once these tests are complete, the medical team gives final confirmation of feasibility and proposes a precise treatment protocol, usually planned over two weeks on site.
3. Adaptation, when standard phages are not enough
In complex cases, no phage in the Georgian pharmacopoeia is aggressive enough against your strain. The laboratory then carries out an adaptation: by letting the phages evolve in contact with your bacterium, the microbiologists select and strengthen their virulence until they obtain a personalised preparation. This step is almost systematic with Klebsiella pneumoniae. It adds five to ten days, which is why some stays last three weeks rather than two.
4. Preparing the biological environment
Bacteriophages are sensitive biological entities: they lose effectiveness in an environment that is too acidic. The laboratory therefore analyses the pH of the infected area. If acidity is too high, the doctors put a complementary protocol in place — acidity correction, vitamin courses, autohaemotherapy — to support your immune defences and give the phages the best conditions to act.
Once these tests are complete, the medical team confirms that treatment is feasible and proposes a precise treatment protocol, usually planned over two weeks on site.
Step 4: applying the phages according to your infection
Active treatment is adapted to the location of the infection, to bring the phages into direct contact with the affected tissues.
| Type of infection | Route of administration |
|---|---|
| Urinary tract infections (E. coli, Proteus) | Direct urethral or bladder instillation, in the doctor's office |
| Lung infections (Pseudomonas, Staphylococcus) | Inhalation of phages by nebulisation and aerosols |
| Folliculitis and skin conditions | Local application, impregnated dressings, mesotherapy injections |
| Osteitis and bone and joint infections | Surgical curettage if needed, then application of phages in situ |
| Prosthetic joint infections (knee, hip) | Full joint lavage combining phages and antibiotics to break down the biofilm |
| Intestinal disorders and microbiota | Oral phage solution, combined with a diet and probiotics |
| Chronic sinusitis | Deep sinus lavages performed by an ENT doctor |
| Dental implant infections | Surgical removal of the implant, bone decontamination with phages, mouthwashes |
The baseline treatment, common to all. Whatever the location, all patients drink a bacteriophage solution two to three times a day. This oral treatment includes mandatory therapeutic breaks: these pauses, calculated case by case by the doctors, prevent the bacterium from adapting and developing resistance to the phages.
Step 5: the rhythm of your stay in Tbilisi
Treatment is not a hospital stay. You stay in the city and go to the clinic for your care and check-ups; the rest of your time is your own. Technical procedures — instillations, nebulisations, lavages — are performed at the clinic, while oral intake continues where you are staying, at the times set by the doctor.
Regular laboratory check-ups make it possible to verify that the bacterial load is falling and, if necessary, to adjust the composition of the preparation or the frequency of doses during your stay. This is exactly what remote treatment cannot offer: the ability to adjust course within a few days, with the laboratory in the same building.
For practical arrangements — accommodation, transfers, assistance and interpreting during consultations — the page organising your medical trip explains what is covered and what remains up to you. The budget is detailed on the page cost of phage therapy in Georgia.
Treatment is not a hospital stay. You stay in the city and go to the clinic for your care and check-ups; the rest of your time is your own. Technical procedures — instillations, nebulisations, lavages — are performed at the clinic, while oral intake continues where you are staying, at the times set by the doctor.
Regular laboratory check-ups make it possible to verify that the bacterial load is falling and, if necessary, to adjust the composition of the preparation or the frequency of doses during your stay. This is exactly what remote treatment cannot offer: the ability to adjust course within a few days, with the laboratory in the same building.
For practical arrangements — accommodation, transfers, assistance and interpreting during consultations — the page organising your medical trip explains what is covered and what remains up to you. The budget is detailed on the page cost of phage therapy in Georgia.
Unable to travel?
A phagogram can be carried out on a sample shipped from Europe, without you having to travel. This route has its limits — no local procedures, no real-time adjustment — but it shows whether active phages exist against your strain before you consider a stay. The shipping conditions, which are strictly regulated, are detailed on the page sending a sample to Georgia.
Step 6: returning home and consolidation
You go home with a supply of phages matching your personalised preparation, to be stored in the refrigerator between 2 and 8 °C. Treatment continues on your own for at least one to two months, following the schedule of doses and breaks set by the doctors.
Follow-up remains active: you stay in contact with the medical team, you send the results of check-up tests carried out in your own country, and a resupply can be arranged if treatment needs to be extended. For long-standing chronic infections, this consolidation phase matters as much as the two weeks spent in Tbilisi: it is what prevents the infection from coming back.
Typical timeline of your treatment
Week 1 (at the clinic in Tbilisi):
Arrival consultation, sampling at the site of infection, culture, phagogram and pH analysis. Your tailor-made protocol is finalised at the end of this week.
Weeks 2 to 3 (intensive treatment in Tbilisi):
Local and oral administration of phages under medical supervision, with regular laboratory check-ups. Doses and technical procedures (ENT, surgery, lavages) are adjusted during the stay.
Weeks 4 to 8+ (consolidation at home):
You go home with your personalised phage supply and continue treatment on your own for one to two months, staying in remote contact with the medical team.
Who does what in your care pathway
The Eliava Institute doctors
They establish the indication, decide whether treatment is feasible, prescribe the phage preparation, perform the technical procedures and provide medical follow-up, both on site and remotely. All medical decisions are theirs.
Se soigner en Géorgie, your facilitator
Translation of your file and interpreting during your consultations, forwarding to the doctors, appointment booking, organisation of your stay and on-site assistance. The facilitator gives no medical advice, prescribes no treatment and sells no phages.
This distinction is not a formality: it explains why the announced timeframes depend on the laboratory and not on the facilitator, and why an answer to a medical question will always come from the doctors, after translation. To learn more about who is involved, see the pages on the Eliava Institute and on Dr. Alain Dublanchet, the leading French-speaking expert on the subject.
What this protocol cannot do
Phage therapy treats bacterial infections only. It has no effect on viral or fungal infections, and it is neither a cancer treatment nor a treatment for autoimmune diseases.
It also requires a bacterium that can be identified from a sample: without a strain to test, a phagogram is impossible. More rarely, no active phage is found against a given strain, or adaptation does not succeed — the prior medical opinion exists to anticipate this.
Finally, the protocol requires a trip of two to three weeks: it is not suitable for life-threatening emergencies or for patients who cannot be transported. Pregnancy and severe immunodeficiency are assessed case by case by the doctors.
Frequently Asked Questions (FAQ)
How long does phage therapy treatment last?
About two months in total. Plan for two to three weeks on site in Tbilisi, the first days of which are devoted to tests, then one to two months of consolidation treatment at home with the phage supply given to you when you leave.
How long do I need to stay in Georgia?
Two weeks in most cases, three when your strain requires the phages to be adapted in the laboratory. The length of stay is confirmed after the prior medical opinion, never before.
Does phage therapy have side effects?
Bacteriophages target only bacteria and cannot infect human cells, which explains why they are well tolerated. Side effects reported in the scientific literature and by Georgian teams are rare and generally mild: local reactions, temporary digestive upset, and sometimes a passing reaction at the start of treatment linked to the rapid destruction of bacteria. No treatment is entirely risk-free, however, and only the Eliava Institute doctors can assess your situation.
Can phages be combined with antibiotics?
Yes, and it is common. Published research describes a synergy between the two: the action of phages can weaken the bacterial wall and restore the bacterium's sensitivity to antibiotics that had stopped working. The combination is decided by the treating doctor based on your antibiogram.
Why are there breaks during treatment?
As with antibiotics, continuous exposure pushes the bacterium to mutate. The strategic breaks set by the doctors keep the phages effective at destroying bacteria throughout the treatment.
What happens if no phage is active against my bacterium?
The laboratory first attempts an adaptation, letting the available phages evolve in contact with your strain. If this adaptation does not succeed, treatment does not go ahead and you are informed — this is one of the reasons why the phagogram always comes before treatment.
Can the phagogram be done without travelling to Georgia?
Yes, by shipping a sample according to a regulated procedure. This option lets you check whether active phages exist before committing to a trip, but it does not replace care on site, which alone allows local procedures and adjustment of the protocol.
Is phage therapy authorised in France?
Not in routine practice. The French medicines agency (ANSM) has opened compassionate access for certain bacteriophages in bone and joint infections, reserved for specific situations and designated hospital teams. In Georgia, phage therapy has been a routine treatment for decades. Let your own doctor know about your plans: continuity of follow-up when you return depends on it.
Is phage therapy possible for children?
It is used in children in Georgia, with adapted dosages and with the doctors' agreement after reviewing the file. The key points to know before planning a stay with a child are covered on the page phage therapy for children.
Is your infection resistant to antibiotics?
Have your file reviewed free of charge by the Eliava Institute doctors. Reply within 5 working days, with no obligation.
Sources
- World Health Organization — Antimicrobial resistance
- Inserm — Antibiotic resistance report (in French)
- ANSM — Compassionate access for bacteriophages in bone and joint infections (in French)
- PubMed — publications on phage therapy
Se soigner en Géorgie is a facilitation service: translation, coordination and organisation of the stay are handled by its team; diagnosis and treatment are exclusively the responsibility of the Eliava Institute doctors. This page is for information only and does not constitute a consultation, medical advice or a promise of results. It does not replace the advice of your own doctor.