An international Delphi survey on priorities in antimicrobial resistant infections therapeutic research. A preliminary study of MePRAM project

Abstract 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.