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An international Delphi survey on priorities in antimicrobial resistant infections therapeutic research: A
Francesco Cogliati Dezza1, Paula Olivares Navarro2, Maria Giulia Caponcello2
1Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Departamento de Medicina, Universidad de Sevilla, Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Seville, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Background:
Due to the public health, economics and societal impacts of antibiotic-resistant bacteria, it is urgent to establish the research priorities for clinical trials development in the antimicrobial resistance (AMR) field. The objective of this study was to derive a consensus document on the prioritization of AMR topics for the development of randomized trials.
Methods:
We performed a survey using the Delphi methodology to establish a consensus among international experts on AMR priority. The questionnaire consisted of 114 items divided in four domains (1.Microorganisms and antimicrobial resistance, 2.Clinical syndromes, 3.Specific populations, 4.Anti-infective agents). The survey was administered to 60 experts using REDCap platform between January and September 2024. Consensus was defined as a simple or cumulative agreement ≥ 70 %. After each round, the results were discussed in Steering Committee meetings and feedback was provided to the experts. A final meeting was held to finalize the priority lists.
Results:
Consensus was reached in 101 items with high priority in 47 items. We elaborated four ranked priority list in the microorganisms and antimicrobial resistance domain divided in four different sections, one priority list addressing the clinical syndromes domain, one priority list addressing the specific populations domain, two priority list on anti-infective agents divided in old and new drugs. Finally, we included a 5th domain, consisting of mixed of previous sections. A priority list for each section was proposed.
Conclusions:
We have established priority lists on AMR-related aspects. The priority list included pathogens, syndromes, populations and drugs and should be useful to drive future clinical research in AMR.
Insights
This study prioritized antimicrobial resistance (AMR) research for clinical trials. Experts identified key pathogens, syndromes, populations, and drugs to guide future AMR clinical research and development.
Area of Science:
- Infectious Diseases
- Clinical Research
- Public Health
Background:
- Antibiotic-resistant bacteria pose significant public health, economic, and societal threats.
- Urgent need to establish research priorities for clinical trials in antimicrobial resistance (AMR).
Purpose of the Study:
- To derive a consensus document on prioritizing AMR topics for randomized clinical trial development.
- To identify key areas for future AMR research.
Main Methods:
- Delphi methodology survey administered to 60 international AMR experts.
- Questionnaire covered 114 items across four domains: microorganisms, clinical syndromes, specific populations, and anti-infective agents.
- Consensus defined as ≥70% agreement; results finalized in steering committee meetings.
Main Results:
- Consensus reached on 101 items, with 47 identified as high priority.
- Developed ranked priority lists for microorganisms, clinical syndromes, specific populations, and anti-infective agents (old and new drugs).
- A fifth domain combined elements from previous sections, with a priority list for each.
Conclusions:
- Established priority lists for AMR-related aspects including pathogens, syndromes, populations, and drugs.
- These lists will guide future clinical research in the AMR field.
- Aims to accelerate the development of effective treatments and strategies against antimicrobial resistance.
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