The ARLG congratulates Vance Fowler, MD, MHS, on being named the 2026 recipient of the Hamao Umezawa Memorial Award, the highest honor presented by the International Society of Antimicrobial Chemotherapy (ISAC) for outstanding contributions to antimicrobial chemotherapy.

Dr. Fowler, ARLG Co-Principal Investigator and Florence McAlister Distinguished Professor of Medicine and Professor of Molecular Genetics and Microbiology at Duke University, has helped shape the field through decades of leadership in Staphylococcus aureus research, antibacterial resistance, and clinical trials. Since ARLG’s launch in 2013, his leadership has supported a global portfolio of studies advancing evidence to improve the diagnosis, prevention, and treatment of antimicrobial-resistant infections.

He will be recognized at the 34th International Congress of Antimicrobial Chemotherapy in Manila, Philippines where he will deliver the Hamao Umezawa Memorial Award Plenary Lecture, “Bridging the Gap: From Staphylococcus aureus Benchmarks to Breakthrough Clinical Trials.”

Learn more about Dr. Fowler’s work and the ISAC award.

The FAST randomized clinical trial, published in JAMA, evaluated whether rapid antimicrobial susceptibility testing (AST) directly from positive blood cultures could improve outcomes for patients with gram-negative bloodstream infections compared with standard testing.

The trial results are also highlighted in a JAMA editorial as well as a JAMA research summary and Editors’ Summary podcast. These materials place the FAST findings in the broader context of antimicrobial resistance, diagnostic innovation, and antibiotic stewardship.

The multinational trial included 850 patients in the primary analysis across seven medical centers in Greece, India, Israel, and Spain – regions with high levels of antimicrobial resistance. Patients were randomized to rapid phenotypic AST plus standard testing or standard testing alone, with antimicrobial stewardship teams reviewing all patients and providing treatment recommendations.

The study found that rapid AST was not superior to standard AST for achieving a more desirable day-30 outcome using a Desirability of Outcome Ranking (DOOR) endpoint. However, rapid testing was associated with faster antibiotic escalation or de-escalation, a finding that may help inform how rapid diagnostic tools are used alongside stewardship programs in clinical practice.

• Learn more: “Fast Antimicrobial Susceptibility Testing for Gram-Negative Bacteremia: The FAST Randomized Clinical Trial”
• Read the JAMA editorial: “A Multinational Trial of Rapid Antimicrobial Susceptibility Testing Is FASTer Better?”
• Listen to the JAMA Editors’ Summary Podcast
• Read the JAMA Research Summary

A recent Open Forum Infectious Diseases editorial highlights the development and application of the ARLG’s Desirability of Outcome Ranking (DOOR) endpoint for acute bacterial skin and skin structure infection (ABSSSI) trials. DOOR is a patient-centric benefit-risk framework that ranks each participant’s overall outcome by incorporating clinical response, complications, adverse events, and mortality, rather than evaluating benefits and harms separately.

The manuscript, “Development and Application of a Desirability of Outcome Ranking (DOOR) Endpoint for Acute Bacterial Skin and Skin Structure Infections,” describes how a multidisciplinary committee adapted an infectious diseases DOOR endpoint for ABSSSI and retrospectively applied it to two previous randomized registrational trials, OASIS-1 and OASIS-2, both comparing omadacycline with linezolid. The study team found that DOOR can be used in ABSSSI clinical trials to help individual patients and clinicians better understand the risks and benefits of different treatment options for skin infections.

The editorial, “What’s Behind DOOR Number 2? Recent Applications From Post-Hoc Analyses of Infectious Diseases Randomized Clinical Trials,” underscores the value of DOOR as an innovative, supplemental strategy to compare the benefits and risks of treatments being evaluated in infectious disease trials, including ABSSSI studies.

The ARLG has incorporated DOOR across a range of studies and, in collaboration with the National Institutes of Health (NIH), the US Food and Drug Administration (FDA), and patient advocate representatives, has developed standardized DOOR outcomes for multiple infectious syndromes.

Visit the ARLG Innovative Research Tools and Methods page for more information about DOOR and tools to design studies using DOOR endpoints.

Two ARLG multicenter trials, FAST and DOTS, were highlighted in a late-breaking session at the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Global Congress on April 18. The studies were two of four chosen for the high‑profile session, emphasizing the ARLG’s significant international impact on antibiotic resistance research.

FAST (Fast Antimicrobial Susceptibility Testing for Gram-Negative Bacteremia), published in JAMA, evaluated whether rapid antibiotic susceptibility testing improves outcomes for patients with serious Gram-negative bloodstream infections. The randomized trial enrolled more than 800 patients across four countries with high levels of antibiotic resistance. While rapid testing enabled clinicians to adjust treatment about 14 hours sooner, it did not improve patients’ overall survival or complication free outcomes at 30 days compared with standard testing. However, in a subgroup of patients with carbapenem-resistant infections, faster testing was associated with fewer patients still hospitalized at day 30.

DOTS (Dalbavancin as an Option for Treatment of Staphylococcus aureus Bacteremia), examined a two dose dalbavancin regimen for S. aureus bloodstream infections. A secondary analysis, published in JAMA Network Open, detailed findings from pharmacokinetic data from 97 patients. The analysis showed that drug exposure varied across patients and was influenced by kidney function, age, weight, and albumin levels. Successful outcomes were significantly more likely in patients who had higher drug levels at around three weeks of treatment. These findings suggest that some patients may benefit from individualized dosing approaches.

These ARLG studies provide important high-quality evidence to guide smarter, safer treatment for serious antibiotic-resistant infections.

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Emily Lydon, MD, an ARLG Early-Stage Investigator Seed Grant recipient, was honored with an Emerging Generation Award from the American Society for Clinical Investigation (ASCI) for her career in research. This award highlights Dr. Lydon’s meaningful contributions to the field of infectious diseases as an early-career physician-scientist.

Dr. Lydon’s work focuses on using multi-omic profiling and advanced computational methods to better understand host-pathogen interactions and develop innovative diagnostic tests for lower respiratory tract infections, particularly in immunocompromised patients. As an ARLG mentee, Dr. Lydon led the Integrated Metagenomic PROfiling to adVancE LRTI diagnosis and stewardship in lung transplant (IMPROVE-LRTI) study. This research aims to differentiate true infection from microbial colonization in lung transplant recipients, create a host-microbial classifier for accurate LRTI diagnosis, and assess how antibiotic exposure affects antimicrobial resistance genes in these patients. If successful and implemented in clinical practice, this test would help to combat the antibacterial resistance crisis by decreasing the number of antibiotics unnecessarily prescribed to lung transplant recipients.

Dr. Lydon is currently a post-doctoral fellow in Infectious Diseases at the University of California, San Francisco, where she is continuing her important work to improve precision diagnostics for infectious diseases, promote antimicrobial stewardship, and improve clinical outcomes for immunocompromised and transplant patients with infectious diseases.

Read the ASCI Emerging Generation Award article to learn more about Dr. Lydon’s research for which she earned this important recognition of her work to improve care for patients with infectious diseases.

Every year, the Congress of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) brings together experts in infectious diseases and clinical microbiology, including many ARLG members. ESCMID Global 2026 was held on April 17-21 in Munich, Germany, with live streaming of sessions for virtual attendees. Check out the list below of ARLG members who presented and chaired events, and view the ESCMID Global 2026 abstracts.

ARLG Member Presentations at ESCMID Global 2026

ARLG Member Posters at ESCMID Global 2026

A new manuscript in Nature Communications discusses the global effort to support phage therapy and features ARLG’s research along with other collaborative initiatives. “Considerations and perspectives on phage therapy from the Transatlantic Taskforce on Antimicrobial Resistance (TATFAR)” details discussions from key meetings in 2023 and 2024 where experts and regulatory authorities from the United States, Canada, the European Union, Norway, and the United Kingdom examined the scientific, regulatory, and logistical challenges surrounding phage therapy.

The publication aims to fill critical research gaps, support therapeutic research and development, and accelerate the translation of phage therapeutics into clinical practice.
This TATFAR initiative to advance phage therapy was collaborative effort among several domestic and international agencies including the National Institute of Allergy and Infectious Diseases (NIAID), the US Food and Drug Administration (FDA), UK Medicines and Healthcare products Regulatory Agency (MHRA), European Medicines Agency (EMA), Health Canada, and the European Commission’s Health Emergency Preparedness and Response Authority (HERA).

The insight provided by TATFAR helps to clarify the current landscape of phage therapy on a global scale and guide its direction in the future. These and other collaborative efforts inform the broader goal to advance evidence-driven approaches that will combat the threat of antimicrobial resistance worldwide.

Read the full publication