GARDP Articles – GARDP https://gardp.org Global Antibiotic Research and Development Partnership Mon, 13 Jul 2026 07:40:58 +0000 en-US hourly 1 https://wordpress.org/?v=7.1.3 https://gardp.org/wp-content/uploads/2026/07/favicon-150x150.png GARDP Articles – GARDP https://gardp.org 32 32 AntibioticDB: An Updated and Improved Open-Access Database for the Antibacterial Research and Development Community https://gardp.org/antibioticdb-an-updated-and-improved-open-access-database-for-the-antibacterial-research-and-development-community/ Mon, 23 Feb 2026 14:25:02 +0000 https://gardp.org/antibioticdb-an-updated-and-improved-open-access-database-for-the-antibacterial-research-and-development-community/ ACS Pub(700 x 430 px)

AntibioticDB (https://www.antibioticdb.com/), originally established in 2017 and since 2021 led by the Global Antibiotic Research & Development Partnership (GARDP), is a freely available database of antibacterial agents to facilitate research and development of new antibacterial therapeutics. Here, we describe a new release of AntibioticDB that has been significantly expanded and updated with the aid of user feedback and which offers additional functionality through a redesigned web portal.

 

Authors

Luiza H. Galarion, Alan Hennessy, Simon D. Harding, Jane F. Armstrong, Astrid Pentz-Murr, Jamie A. Davies, Alex J. O’Neill, Laura J. V. Piddock

 

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]]> Pharmacokinetics and safety of fosfomycin and flomoxef administered as part of neonatal sepsis treatment (NeoSep1 Part 1) https://gardp.org/pharmacokinetics-and-safety-of-fosfomycin-and-flomoxefadministered-as-part-of-neonatal-sepsis-treatment-neosep1-part-1/ Mon, 29 Dec 2025 14:49:03 +0000 https://gardp.org/pharmacokinetics-and-safety-of-fosfomycin-and-flomoxefadministered-as-part-of-neonatal-sepsis-treatment-neosep1-part-1/ ASM (700 x 430 px)

Neonatal doses for the off-patent antibiotics fosfomycin and flomoxef, flomoxef,which offer coverage against many extended-spectrum beta-lactamase (ESBL)-producing organisms, are based on limited data. We performed a pharmacokinetic (PK) and safety study of fosfomycin and flomoxef to confirm proposed neonatal dosing before further investigation in a trial (NeoSep1, ISRCTN48721236).

Authors

Adrie Bekker, Navarat Panjasawatwong, Louise F. Hill, Wolfgang Stohr, A. Sarah Walker, Sally Ellis, Angela Dramowski, Andrew Whitelaw, Christina Obiero, James A. Berkley, Alexander Makazi, Sithembiso Velaphi, Reenu Thomas, Petronella Magagula, Ilhaam Abrahams, Firdose L. Nakwa, Mohammed M. Barday, Alison Van Kwawegen, Kamla Pillay, Silke Gastine, Joseph F. Standing, Peter Skoutari, Francesca Schiavone, Mike Sharland, Seamus O’Brien, Julia A. Bielicki, Tim R. Cressey, On behalf of the NeoSep Study Team

 

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]]> Carbapenem-resistant Enterobacterales among patients with bloodstream infections in South Africa: Consolidated surveillance data, 2015–2021 https://gardp.org/carbapenem-resistant-enterobacterales-among-patients-with-bloodstream-infections-in-south-africa-consolidated-surveillance-data-2015-2021/ Thu, 03 Jul 2025 09:26:09 +0000 https://gardp.org/carbapenem-resistant-enterobacterales-among-patients-with-bloodstream-infections-in-south-africa-consolidated-surveillance-data-2015-2021/ PLOS ONE (700 x 430 px)

A fifth of blood cultures from patients with infections acquired in a healthcare setting in South Africa will yield an organism. Carbapenem-resistant Enterobacterales (CREs), specifically Klebsiella pneumoniae are the most predominant Gram-negative bacteria (GNB) isolated among bloodstream infections (BSI). Additionally, the multidrug-resistant nature of these organisms is not only a threat to patients but it also poses a big public health challenge to current treatments and highlights the need for the development of new antimicrobials. Therefore, CRE have been placed on the critical priority list by the World Health Organization (WHO). We aimed to provide a holistic overview of the GERMS-SA CRE BSI surveillance data from 01 July 2015–31 December 2021.

Authors

Husna Ismail, Thembekile Buhle Christna Zwane, Elloise Du Toit, Renata Maria Augusto da Costa, François Franceschi, Olga Perovic

 

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]]> Global health perspectives on antibacterial drug discovery and the preclinical pipeline https://gardp.org/global-health-perspectives-on-antibacterial-drug-discovery-and-the-preclinical-pipeline/ Fri, 28 Mar 2025 13:06:51 +0000 https://gardp.org/global-health-perspectives-on-antibacterial-drug-discovery-and-the-preclinical-pipeline/ NatureReviewsMicrobiology MediaCoverage Thumbnail

Antibacterial resistance is a global challenge that requires a coordinated international response. The current clinical pipeline largely consists of derivatives of established antibiotic classes, whereas the discovery and preclinical pipeline is diverse and innovative including new direct-acting agents with no cross-resistance with existing antibiotics. These novel compounds target pathways such as lipoprotein synthesis, lipopolysaccharide biosynthesis and transport, outer membrane assembly, peptidoglycan biosynthesis, fatty acid biosynthesis and isoprenoid biosynthesis. If these agents can be developed into safe, effective and affordable drugs, they could address a broad range of infections worldwide, benefiting large patient populations without geographical limitations. However, strategies such as indirect-acting or pathogen-specific treatments are likely to benefit small patient groups, primarily in high-income countries that have advanced health-care systems and diagnostic infrastructure. Although encouraging, the discovery and preclinical pipeline remains insufficiently robust to offset the high attrition rates typical of early-stage drug innovation and to meet global health needs.

Authors

Ursula Theuretzbacher, Ravindra P. Jumde, Alan Hennessy, Jennifer Cohn, Laura J. V. Piddock

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]]> Combining antibiotics to tackle antimicrobial resistance https://gardp.org/combining-antibiotics-to-tackle-antimicrobial-resistance/ Wed, 26 Mar 2025 15:04:53 +0000 https://gardp.org/combining-antibiotics-to-tackle-antimicrobial-resistance/ Nature media coverage thumbnail

Authors

William Hope, Sumathi Nambiar, Seamus O’Brien, Michael Sharland, David L. Paterson, Mo Yin, Ian H. Gilbert, Michael Ferguson, Sharon J. Peacock, Iain Buchan, Nada Reza, Vineet Dubey, Christopher A. Darlow, Alessandro Gerada & Alex Howard on behalf of Pre-X Investigators

 

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]]> Using a Difficult-to-treat Resistance Index to Gauge Imbalance between Countries’ Antibiotic Resistance Prevalence and Access to Antibiotics: A Scoping Review and Concept Proposal https://gardp.org/using-a-difficult-to-treat-resistance-index-to-gauge-imbalance-between-countries-antibiotic-resistance-prevalence-and-access-to-antibiotics-a-scoping-review-and-concept-proposal/ Sat, 01 Mar 2025 13:45:45 +0000 https://gardp.org/using-a-difficult-to-treat-resistance-index-to-gauge-imbalance-between-countries-antibiotic-resistance-prevalence-and-access-to-antibiotics-a-scoping-review-and-concept-proposal/ Sceince Direct (700 x 430 px)

Antimicrobial resistance (AMR) remains a major threat that is worsened by global disparities in access to antibiotics. At the United Nations General Assembly second high-level meeting for AMR in September 2024, member nations declared a commitment to improve equitable access to antimicrobials particularly in low- and middle-income countries (LMICs).[1] However, mechanisms to capture the impact of improved antibiotic access remain unclear as access limitations do not feature within AMR definitions or burden estimates. A recent epidemiological analysis that estimated 1.14 million AMR-attributable deaths globally in 2021[2] did not consider impacts of two key treatment challenges: antibiotic access limitations or even resistance to multiple antibiotics.

 

Authors

Morgan K. Walker, Emad A. Chishti, Christina Yek, Sadia Sarzynski, Sahil Angelo, Jennifer Cohn, Alicia A. Livinski, Sameer S. Kadri

 

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]]> Advancing global antibiotic research, development and access https://gardp.org/advancing-global-antibiotic-research-development-and-access/ Tue, 03 Sep 2024 13:24:24 +0000 https://gardp.org/advancing-global-antibiotic-research-development-and-access/ The pipeline of new antibiotics is insufficient to keep pace with the growing global burden of drug-resistant infections. Substantial economic challenges discourage private investment in antibiotic research and development  (R&D), with a decline in the number of companies and researchers working  in the field. Compounding these issues, many countries (from low income to high income) face a growing crisis of antibiotic shortages and inequitable  access to existing and emerging treatments. This has led to an increasing role for public and philanthropic funding in supporting antibiotic R&D via the creation of nonprofit public–private partnerships, including Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X) and the Global Antibiotic Research and Development Partnership (GARDP), industry support for the AMR Action Fund, and pilot schemes to evaluate and reimburse antibiotics in innovative ways. Now is the time to raise the urgency, ambition and commitments of the world’s leaders to fully support the antibiotic R&D ecosystem, incentivizing all sectors to conduct public health-driven antibiotic R&D and make effective antibiotics accessible to all who need them.
Authors
Laura J. V. Piddock, Yewande Alimi, James Anderson, Damiano de Felice, Catrin E. Moore, John-Arne Røttingen, Henry Skinner & Peter Beyer

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]]> Challenges and Opportunities with Antibiotic Discovery and Exploratory Research https://gardp.org/challenges-and-opportunities-with-antibiotic-discovery-and-exploratory-research/ Thu, 29 Aug 2024 09:38:08 +0000 https://gardp.org/challenges-and-opportunities-with-antibiotic-discovery-and-exploratory-research/ Discovery and exploratory research can identify new antibiotics and biological targets. However, failure rates are high, and funding is insufficient to solve the scientific challenges and attract researchers to antibacterial R&D. Novel methods, including artificial intelligence, have been applied to early-stage research, but these have yet to deliver new antibiotics. The Global Antibiotic Research & Development Partnership (GARDP) is investing in discovery and exploratory research and an R&D education and outreach program. GARDP’s efforts, including application of novel R&D methods and new global networks of R&D researchers to develop new antibiotics, is helping address antimicrobial resistance sustainably over the long-term.

Authors

Laura J. V. Piddock, Rohit Malpani, and Alan Hennessy

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]]> Improving equitable access for effective antibacterial: an ecosystem approach https://gardp.org/improving-equitable-access-for-effective-antibacterial-an-ecosystem-approach/ Thu, 18 Jul 2024 08:20:37 +0000 https://gardp.org/improving-equitable-access-for-effective-antibacterial-an-ecosystem-approach/ Antibiotics are indispensable to modern healthcare, yet their equitable access remains a pressing global challenge. Factors contributing to inequities include insufficient evidence for optimal clinical use, limited registration, pricing for Reserve antibiotics, and supply chain challenges. These issues disproportionately affect low- and middle-income countries, exacerbating antimicrobial resistance burdens.

This paper explores the multifaceted dimensions of inequitable antibiotic access and proposes a comprehensive framework to address the crisis.

 

Authors

Jennifer Cohn, Manica Balasegaram, Hema Srinivasan, Leena Menghaney, Mirfin Mpundu, Brenda Waning, Yewande Alimi

 

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]]> Determining sample size in a personalized randomized controlled (PRACTical) trial https://gardp.org/determining-sample-size-in-a-personalized-randomized-controlled-practical-trial/ Tue, 09 Jul 2024 14:45:04 +0000 https://gardp.org/determining-sample-size-in-a-personalized-randomized-controlled-practical-trial/ In clinical settings with no commonly accepted standard-of-care, multiple treatment regimens are potentially useful, but some treatments may not be appropriate for some patients. A personalized randomized controlled trial (PRACTical) design has been proposed for this setting. For a network of treatments, each patient is randomized only among treatments which are appropriate for them. The aim is to produce treatment rankings that can inform clinical decisions about treatment choices for individual patients. Here we propose methods for determining sample size in a PRACTical design, since standard power-based methods are not applicable. We derive a sample size by evaluating information gained from trials of varying sizes. For a binary outcome, we quantify how many adverse outcomes would be prevented by choosing the top-ranked treatment for each patient based on trial results rather than choosing a random treatment from the appropriate personalized randomization list. In simulations, we evaluate three performance measures: mean reduction in adverse outcomes using sample information, proportion of simulated patients for whom the top-ranked treatment performed as well or almost as well as the best appropriate treatment, and proportion of simulated trials in which the top-ranked treatment performed better than a randomly chosen treatment. We apply the methods to a trial evaluating eight different combination antibiotic regimens for neonatal sepsis (NeoSep1), in which a PRACTical design addresses varying patterns of antibiotic choice based on disease characteristics and resistance. Our proposed approach produces results that are more relevant to complex decision making by clinicians and policy makers.

 

Authors

Rebecca M. Turner, Kim May Lee, A. Sarah Walker, Sally Ellis, Michael Sharland, Julia A. Bielicki, Wolfgang Stöhr, Ian R. White

 

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