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Antimicrobial (Drug) Resistance

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NIAID Antibacterial Resistance Clinical Research Activities

Clinical research projects related to antibacterial resistance focus on the safety and effectiveness of new antimicrobial therapeutics, vaccines, diagnostics, and prevention strategies. In addition, NIAID supports a number of studies on optimizing use of existing drugs. An important goal of this research is to identify treatment regimens that limit the emergence of drug resistance, which is a growing problem in treating infectious diseases.

The NIAID clinical research program on antibacterial resistance includes both clinical studies and clinical trials. Clinical studies involve human subjects but typically do not test products or interventions. In contrast, clinical trials evaluate the safety and effectiveness of diagnostic, preventive, and therapeutic products or interventions in human subjects. NIAID supports clinical research through grants, cooperative agreements, and a variety of contracts, as well as clinical research services that support planning and conduct of clinical research and oversight activities for human subject protection.

Highlights include research in the following areas:

  • Development of a test to rapidly identify Mycobacterium tuberculosis, including multidrug-resistant strains ("Xpert MTB and Rifampin resistance" assay)
  • Safety, drug absorption, distribution, and best dosage of a novel narrow spectrum agent with activity against intestinal bacterium Clostridium difficile (Phase I study)
  • Safety, drug absorption, distribution, and best dosage of single-daily doses of an experimental tuberculosis treatment, SQ109 (Phase IB/C studies)
  • Safety and immune response generated by an experimental preventive vaccine (i.e., detoxified J5 core glycolipid/ Group B meningococcal outer membrane protein vaccine) for Gram-negative bloodstream infection (Phase I study)
  • Decontamination of endotracheal tubes to reduce healthcare-associated infections and emergence of resistance (Phase I study)
  • Nasal decolonization of Staphylococcus aureus using novel, topical agent (Phase I study)
  • Nasal decolonization of methicillin-resistant S. aureus (MRSA) using topical antibiotic in neonatal intensive care units
  • Optimal utilization of older antibiotics (such as Colistin) to determine proper dosage, limit toxicity, and reduce emergence of resistance
  • Utilization of oral "first-line" antibiotics (such as trimethoprim sulfamethoxazole, clindamycin, and cephalexin) that are no longer under patent to effectively treat skin and soft tissue infections (SSTI) caused by community-acquired methicillin-resistant S. aureus  (CA-MRSA) in order to preserve "last-line" agents. These trials are also evaluating whether certain forms of CA-MRSA can be managed surgically without antibiotics (e.g., through drainage and wound care).
  • Shortened duration of therapy for staphylococcal infections in the bloodstream, including catheter-related infections, to reduce emergence of resistance
  • Shortened duration of therapy for urinary tract infections in children to reduce emergence of resistance
  • Treatment of acute otitis media in children; strategies include determining the need for antibiotic treatment and shortening duration of therapy to reduce emergence of resistance
  • Optimization of rapid diagnostic point-of-care tests to guide treatment decisions for patients with community-acquired pneumonia
  • Optimizing the use of Colistin to treat Gram-negative bacteremia (e.g., Acinetobacter)
  • Optimizing the treatment of ventilator-associated pneumonia caused by Acinetobacter and Pseudomonas
  • Treatment of gonorrhea using two antibiotic therapies in combination (i.e., gentamicin/ azithromycin vs. gemifloxacin/azithromycin)

Further information about these and other NIAID-supported antimicrobial resistance research projects can be found using the RePORT (Research Portfolio Online Reporting Tools) website.

RePORT provides access to a variety of reporting tools, reports, data, and analyses of National Institutes of Health (NIH) research activities. One of the tools available on the RePORT site is the RePORTER (RePORT Expenditures and Results) module. RePORTER is an electronic tool that allows users to search a repository of NIH-funded research projects and access publications and patents resulting from NIH funding.

For more information on NIAID-supported antibacterial resistance research, please see

Last Updated March 11, 2014