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 of the CIBER MePRAM project has resulted in several priority lists—microorganisms, clinical syndromes, patient populations and anti-infective treatments—with the aim of guiding future research from a personalised medicine perspective.

An international study led by the Biomedical Research Networking Centre (CIBER), with the participation of 60 experts, sets out a roadmap for clinical research to address 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, given its impact on public health, the sustainability of healthcare systems, the economy and society as a whole.

The study identifies as especially high priority the most severe infections caused by bacteria resistant to multiple antibiotics, including some common in hospitals, 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 (bacteraemia) caused by multidrug-resistant bacteria, hospital-acquired pneumonia, endocarditis and febrile neutropenia.

“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; it also incorporates the most relevant clinical syndromes, patient populations with the greatest unmet needs, and the different available anti-infective agents, including both established drugs and new antibiotics,” say researchers from the CIBER Infectious Diseases area. The study was coordinated by Jesús Rodríguez-Baño (Virgen Macarena University Hospital, Institute of Biomedicine of Seville, University of Seville), together with Juan Pablo Horcajada (Hospital del Mar and HMRIB) and Julián de la Torre Cisneros (Maimónides Institute for Biomedical Research of Córdoba and Reina Sofía University Hospital of Córdoba).

The Delphi-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, enabling 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 aim is to facilitate studies that are more efficient, comparable and 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 CIBER MePRAM project, a national initiative committed to a comprehensive strategy against antimicrobial resistance, combining advanced diagnostics, new technologies, clinical research and innovative trial models. “The results obtained provide a consensus 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.

The MEPRAM project is funded through the Precision and Personalised Medicine call of the Carlos III Health Institute (ISCIII), with a total budget of €4,339,500 over three years (2023–2026). The project involves 31 research groups: 26 from CIBERINFEC and three from other CIBER areas, across nine Autonomous Communities, and up to 76 researchers. The principal investigator and project coordinator, Jesús Oteo, is the Scientific Director of CIBERINFEC, a specialist in Microbiology and a researcher at the National Centre for Microbiology (CNM).

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.