Bacteriophage Therapy in Patients With Diabetic Foot Osteomyelitis

Inclusion Criteria:

• Male or female ≥18 to <85 years of age.

• Ongoing diagnosis of diabetes.

• Have undergone or are scheduled to undergo surgical debridement for DFO as part ofSoC, with the associated bone culture positive for S. aureus

• Availability of at least 1 matching phage for S. aureus cultured from the boneculture

• Receiving SoC treatment for DFO, including antibiotics after debridement and beforerandomization

• Meet defined study ulcer requirements as defined in the protocol

• Adequate circulation to the affected extremity demonstrated within 3 months prior torandomization and no revascularization procedure anticipated

• History of compliance with prior appointments and treatments in the investigator'sopinion and willingness to receive and comply with SOC antimicrobial and clinicaltreatments for the study ulcer, including offloading

Exclusion Criteria:

• Healing of the ulcer by more than 30% between screening and randomization.

• Treated with hyperbaric oxygen or cellular/tissue products with 30 days of screening

• Suspicion of neoplasm associated with the study ulcer or any non-study diabeticulcer independent of biopsy result.

• Presence of any cellulitis not localized to the study ulcer.

• Indwelling hardware at the site of the DFO.

• Body weight <50 kg.

• Presence of above ankle ulcer, with >50% above medial malleolus

• Hemoglobin < 7g/dL

• Abnormal liver function tests

• History of underlying liver disease at screening or within last 3 months

• Positive test for HIV-1 and /or HIV-2

• Any other clinically significant or severe disease that in the judgment of theinvestigator makes the patient unfit for the study or likely to withdraw prematurelyfrom the study, or that could jeopardize the safety of the patient or confound theresults of the study.

• Known allergy to phage products.

• Pregnant and/or breastfeeding.

• Immunocompromised at screening in the judgment of the investigator.

• Taking any systemic or topical antibacterial antibiotic within 2 weeks prior to thestart of study treatment, for a condition other than Diabetic Foot Infection andDFO.

• Taking any antiviral medication within 2 weeks prior to the start of study treatmentand up through the last administration of study treatment.

• Taking and/or receiving any therapies for the study ulcer that are not considered tobe SOC.

• More than 30 days has elapsed between screening and randomization (start oftreatment)

• Participating in another clinical trial within 4 weeks prior to screening.

• Inability to obtain or provide informed consent or adhere to the protocol in thejudgment of the investigator.

• Once approximately 30% of subjects are enrolled with DFO involving digits,additional subjects will be excluded.