Antimicrobial resistance (AMR) increasingly complicates the management of musculoskeletal infections (MSI), where biofilm formation and implant-associated infections often necessitate prolonged antibiotic therapy, repeated surgical interventions, and are associated with frequent treatment failure (1). Bacteriophage therapy (PT) has re-emerged as a promising adjunctive strategy, given its specificity, ability to target biofilms, and self-amplifying nature (2). However, clinical implementation remains limited by heterogeneous study designs, lack of standardized protocols, and insufficient clinical evidence (2). The monocentric PHAGEFORCE registry demonstrated the feasibility of PT across five medical indications, with clinical remission in 9/11 (82%) evaluable MSI patients and no serious adverse reactions (3). EPHICACI was developed to overcome its limited scale through a multicenter approach.