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05/02/2026 - Press release

The roadmap for clinical research against antibiotic resistance established

· Infections caused by Enterobacterales, Pseudomonas aeruginosa and Acinetobacter baumannii are identified as priorities for clinical research

· The study, published in the Journal of Infection and Public Health, involved 60 experts who reached consensus on the main priorities for the development of new clinical trials

· The work carried out within the MePRAM project of CIBER has resulted in several priority lists-microorganisms, clinical syndromes, patient populations and anti-infective treatments-aimed at guiding future research from a personalised medicine approach

An international study led by the Biomedical Research Networking Centre (CIBER), with the participation of 60 experts, establishes the roadmap for clinical research in the fight against antibiotic resistance. The work has identified the main priorities for the development of new clinical trials. The aim is to curb what is already considered a global emergency, due to its impact on public health, the sustainability of healthcare systems, the economy and society as a whole.

The study identifies as particularly high priority the most severe infections caused by bacteria resistant to multiple antibiotics, including some that are common in hospital settings, such as Enterobacterales, Pseudomonas aeruginosa and Acinetobacter baumannii. It also highlights severe clinical conditions for which there is still limited evidence regarding the most effective treatment, such as bloodstream infections caused by multidrug-resistant bacteria (bacteraemia), hospital-acquired pneumonia, endocarditis and neutropenic fever.

"Unlike other previously published priority lists, which focus almost exclusively on pathogens, this study adopts a broader and more integrative approach. The analysis is not limited to microorganisms and their resistance mechanisms, but also incorporates the most relevant clinical syndromes, patient populations with the greatest unmet needs, and the different anti-infective agents available, including both classical drugs and new antibiotics," explain researchers from the Infectious Diseases area of CIBER (CIBERINFEC) Jesús Rodríguez-Baño, Head of the Infectious Diseases Department at Virgen Macarena University Hospital, affiliated with the Institute of Biomedicine of Seville (IBiS)/CSIC and Professor of Medicine at the University of Seville, and coordinator of the study together with Juan Pablo Horcajada (Head of the Infectious Diseases Department at Hospital del Mar and coordinator of the Infectious Pathology and Antimicrobials Group at the Hospital del Mar Research Institute in Barcelona - HMRIB) and Julián de la Torre Cisneros (Head of the Infectious Diseases Department at Reina Sofía University Hospital in Córdoba).

From left to right: Jesús Rodríguez-Baño, Julián de la Torre Cisneros and Juan Pablo Horcajada.

The Delphi-method-based survey was conducted between January and September 2024 and involved international experts in infectious diseases and antimicrobial resistance. After several rounds of consultation and discussion, a high level of consensus was reached, allowing the definition of a set of priorities considered particularly urgent and with the greatest potential clinical impact.

"As a result of the process, microorganisms and resistance profiles of particular relevance were identified, as well as clinical syndromes for which the available scientific evidence remains limited. In addition, specific patient populations requiring tailored therapeutic strategies were highlighted, and the study of certain anti-infective treatments-both currently available and next-generation-was prioritised in specific clinical contexts," comment Francesco Cogliati Dezza and Paula Olivares Navarro, co-first authors of the article and researchers in Dr Rodríguez-Baño's CIBERINFEC team.

These priorities constitute a practical tool to guide the design of future randomised clinical trials, particularly those based on innovative personalised medicine approaches, such as adaptive trials. The goal is to facilitate more efficient, comparable studies aligned with the real needs of clinical practice.

This work, published in the Journal of Infection and Public Health, represents one of the main outcomes of the MePRAM project of CIBER, a national initiative that promotes a comprehensive strategy against antimicrobial resistance by combining advanced diagnostics, new technologies, clinical research and innovative trial models. "The results obtained provide a consensus-based roadmap that can make a decisive contribution to improving clinical research and, ultimately, the management of infections caused by multidrug-resistant microorganisms," the research group concludes.

Article reference:

Cogliati Dezza F, Olivares Navarro P, Caponcello MG, Salazar Moscoso M, Cosano Pérez P, Retamar Gentil P, et al. An international Delphi survey on priorities in antimicrobial resistant infections therapeutic research: A preliminary study of MePRAM project. J Infect Public Health. 2025;40:100862. doi: 10.1016/j.jgar.2025.01.002.

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