ARLG Co-Principal Investigator, Vance Fowler, MD, and Helen Boucher, MD, ARLG Executive Committee Member and Innovations Working Group Chair, shared their insights on the current state of antimicrobial resistance (AMR) in a recent article published by the Association of American Medical Colleges (AAMC). The article, “Where are we in the battle against antibiotic-resistant infections?,” also included their strategies to combat this global health crisis.

Dr. Boucher, an Infectious Disease (ID) Specialist, Dean of the Tufts University School of Medicine, and Chief Academic Officer of Tufts Medicine, emphasized practicing infection prevention and antibiotic stewardship to decrease rates of antibiotic-resistant bacteria in hospitals. The development of diagnostic tests to determine if an infection is bacterial or viral is another promising avenue to combat AMR. However, Dr. Boucher notes, it has been challenging to determine how best to use the tests and make them cost effective.

Dr. Fowler, ID Specialist and Professor of Medicine at Duke University School of Medicine, highlighted the need for renewed investment in the development of antibiotics by the pharmaceutical industry, which could be supported through the PASTEUR Act if passed by Congress. Bacteriophage therapy is emerging as a strong potential treatment for antibiotic-resistant infections. Dr. Fowler served as Chair of a blinded independent adjudication committee to evaluate the results of a phase 2 trial conducted at UCLA. The study showed promising results for a phage “cocktail” used in combination with standard of care antibiotics to treat patients with complicated Staphylococcus aureus infections.

The AAMC article also cites antimicrobial use in livestock and agriculture and ID workforce shortages as other areas that need to be addressed to combat the AMR crisis.

Read the article on the AAMC website.

Congratulations to the ARLG Steering Committee members who received recognition as one of Clarivate’s Highly Cited Researchers in 2025! Clarivate uses a meticulous process to identify researchers who have significantly influenced their fields during the past year. Learn more about the important work these leaders in antimicrobial resistance are doing to improve patient care by advancing the prevention, diagnosis, and treatment of infections caused by antibiotic-resistant bacteria:

• Vance Fowler, MD, MHS, Duke University (Cross-Field)
• David van Duin, MD, PhD, FIDSA, FAST, University of North Carolina (Immunology)
• Yohei Doi, MD, PhD, University of Pittsburgh (Immunology)
• David Paterson, National University of Singapore (Pharmacology and Toxicology)

We are pleased to announce that the PHAGE study has successfully reached database lock. This Phase 1b/2 clinical trial investigated the safety profile and microbiological activity of bacteriophage therapy in individuals with cystic fibrosis (CF) who are chronically colonized with Pseudomonas aeruginosa.

Led by Pranita Tamma, MD, MHS, University of Pennsylvania, and Robert Schooley, MD, University of California, San Diego, the trial enrolled 72 participants across 17 sites. Participants were randomized to receive either a single intravenous dose of a four-component bacteriophage cocktail or a placebo.

The data generated from the PHAGE study will deepen our understanding of optimal dosing strategies, safety considerations, and the expected microbiological responses associated with bacteriophage therapy. Importantly, these findings will guide the design of future clinical trials that aim to advance bacteriophage-based treatments for antimicrobial-resistant infections, extending beyond P. aeruginosa-related lung disease.

For additional details, consult the study record—and stay tuned for forthcoming results.

Congratulations to ARLG Fellow Natalie Mackow, MD, MSCR! Dr. Mackow received the SHEA Trainee award at IDWeek 2025 for her abstract, “Using a novel Anaerobic Activity Index to assess risk for poor outcomes in burn patients in a burn intensive care unit.”

Dr. Mackow’s research aims to inform antibacterial therapy practices in patients with severe burns to reduce the prevalence of antibacterial resistance, which may be applicable to prevention approaches in other critically ill patient populations.

“Systemic antibiotic therapy is an important, potentially modifiable, risk factor for antibacterial resistance in this vulnerable patient population,” says Dr. Mackow. “Additionally, a novel tool to improve our definition of the anti-anaerobic activity of antibacterials has the potential to be utilized broadly in clinical studies and clinical practice, once validated.”

Learn more about Dr. Mackow’s research and how an ARLG Fellowship supported her work to improve outcomes for patients with severe burns in her ARLG Mentee Spotlight.

In a recent article, “DOTS: Optimism Around a ‘Negative’ Dalbavancin Trial,” Dr. Paul Sax summarizes the results of the DOTS study and why the findings are important.

Researchers for the DOTS study wanted to learn if two doses of dalbavancin, a long-lasting antibiotic often used to treat severe, bacterial skin infections, could work better than the standard peripherally inserted central catheter (or PICC line) antibiotic treatment for patients hospitalized for complicated Staphylococcus aureus bloodstream infections. The study results showed that although dalbavancin was not better at treating bloodstream infections, it worked as well as the standard therapy with fewer patients having to stop or change treatment due to side effects.

“So yes, DOTS was ‘negative’ on its primary outcome,” said Dr. Sax. “But it also showed that dalbavancin performs about as well as what we do now, with far less infrastructure: no PICC, no daily infusions, no vancomycin levels, fewer moving parts.”

Learn more about these important findings to improve patient outcomes for antibiotic-resistant infections in the ARLG news and the DOTS Summary of Results.

The results of an ARLG study, Dalbavancin as an Option for Treatment of S. aureus Bacteremia (DOTS), were recently published in JAMA.

In this study, researchers compared the safety and efficacy of dalbavancin to the standard of care in treating patients with complicated Staphylococcus aureus bloodstream infections. Antibiotics for serious S. aureus infections are typically delivered over 4-6 weeks through a central catheter, or PICC line, that requires specialized care and may lead to other complications like additional infections. Results indicate that dalbavancin, delivered in two doses one week apart, can be as effective as the standard of care while avoiding the potential risks associated with a PICC line. These findings are significant because better, safer treatments are needed for S. aureus bloodstream infections, which are common in hospitals and can be deadly.

To learn more about these important findings to improve patient outcomes for antibiotic-resistant infections, read the DOTS summary of results, listen to the JAMA Author Interviews podcast, and check out the Duke Health press release.

Our best wishes go out to Beth Evans, CCRA, on her retirement after 29 years at Duke Clinical Research Institute (DCRI). Since 2016, she has worked with ARLG as a lead CRA on many studies including  HABP/VABP, MDRO, SNAP, CRACKLE-2, POP, SHREC, and PHAGE.

“My passion was to work closely with site personnel, training them and guiding them through the day-to-day study activities,” Beth states. “I loved the details of each study and helping sites understand and follow the protocol. I was often called ‘Eagle Eyes’ for finding details others may have missed.”

In 2021, Beth channeled her passion and expertise into working on the PHAGE study with Drs. Robert “Chip” Schooley and Pranita Tamma to evaluate bacteriophages as a promising alternative to antibiotics. Her experience on the MDRO study as a site manager for the U.S. and Asia-Pacific regions was equally exciting as she traveled to provide study team training at multiple sites across China and Australia. “It was inspiring to see sites across the globe unite on one mission – the fight against antimicrobial resistance,” she states. “Given the growing threat of antibiotic-resistant bacteria, contributing to research that combats this global health issue is very important to me. ARLG is a world leader in the prevention and treatment of infections that could one day directly benefit me or someone close to me.”

Now that Beth has retired, she has no intention of sitting still. She will direct her passion and energy into hiking, paddleboarding, and playing tennis. During the next two years, she hopes to hike the tallest point in every U.S. state. When she isn’t outdoors, Beth plans to spend more time playing piano and may also take banjo lessons.

The ARLG published a new supplement in the journal of Clinical Infectious Diseases titled “In Pursuit of Patient-Centered Antibacterial Trials: Listening to, Learning From, and Leveraging the Patient Perspective.” The supplement includes eight articles authored by ARLG members that describe several challenges and opportunities for measuring health-related quality of life (HRQoL) in patient care and in clinical studies of infectious diseases.

Read the supplement.

Dr. Angelique E. Boutzoukas’ manuscript, “Carbapenem-Resistant Enterobacterales in Solid Organ Transplant Recipients,” was selected as one of the year’s top transplant infectious diseases papers at the 2025 World Transplant Congress. Congratulations on this recognition of your important work, Dr. Boutzoukas!

Marc Bonten, MD, PhD, was recently appointed Vice-Dean of Education and Director of the Education Center (Research) at the University Medical Center (UMC) Utrecht, the Netherlands. In his role as CEO of the European Clinical Research Alliance for Infectious Diseases, Dr. Bonten collaborates with the ARLG to address the global antibacterial resistance crisis.

Read more about Dr. Bonten’s contributions to the field of antibacterial resistance.