ACPHS Professor of Pharmacy Practice, Tom听Lodise, PharmD,听explains that Anti-Microbial听Resistance (AMR)听threatens the foundation of modern medicine, making once-routine infections increasingly difficult to treat.听He听was鈥�by the Antibacterial Leadership Resistance Group as a Highly Ranked Scholar 鈥� Prior 5 Years, for his publications on鈥痸ancomycin, as well as one of the top authors ever cited (putting him at the top two percent of cited authors historically) within Scopus,鈥�‘s 36K-plus title database.鈥�听
In honor of WHO鈥檚 World AMR Awareness Week, from November 18-24,听we asked Dr.听Lodise听to talk to us about his research and how it aims to improve care for patients with AMR infections.听
Why听is听antimicrobial resistance a major听health听threat?
Antimicrobial resistance means the antibiotics we have depended on for decades are losing their power. Most infections are still treatable today, but each year more than 2.8 million resistant infections occur and听over听35,000听people听die as a result in the U.S., according to the CDC.听听
About 30 percent of the听nearly 12听million adults treated for infections听in hospitals, whether admitted with one or developing it during their stay, do not receive an active antibiotic within the first three days. Delays in听appropriate therapy听lead听to more complications,听deaths听and higher costs. Without effective antibiotics, the very foundation of modern medicine begins to crumble. Safe childbirth, organ transplants, joint听replacements听and cancer chemotherapy all depend on being able to prevent and treat infections. Losing antibiotics would set medicine back a century.听
How听do听pharmacometrics,听outcomes听research听and epidemiology fit together?
Antimicrobial resistance threatens the foundation of modern medicine,听making听routine infections harder to treat. My research program brings together pharmacometrics, clinical outcomes research, and epidemiology to improve care for patients with resistant infections.听听
The goal is to develop treatment strategies that are more personalized,听safer听and more effective while reducing drug toxicity and slowing the spread of resistance. Using advanced modeling, we study key processes of care such as how quickly patients receive the right therapy, how rapid diagnostics guide treatment, and how therapeutic drug monitoring improves outcomes. By linking how antibiotics move through the body with how they act against bacteria, we can define exposure levels that achieve cure without causing harm. This approach helps translate complex data into practical strategies that clinicians can use to deliver better care for patients today and preserve antibiotic effectiveness for the future.听
What听have you听learned about听dosing听and exposure?
We have learned that getting the right amount of听antibiotics听to the infection site at the right time can be the difference between success and failure. Too little drug allows infection and resistance to persist, while too听much听increases the risk of toxicity. Even听small differences听in kidney function or body size can dramatically alter antibiotic levels. Through modeling and simulation, we can predict these variations and individualize therapy. This approach allows us to ensure that every patient receives enough drug to cure the infection while minimizing the risk of harm.听
How do you balance听aggressive treatment with stewardship?
Clinicians face a constant challenge: treating infections strongly enough to save lives but not so broadly that it accelerates resistance. Our research provides data that听helps听clinicians strike that balance.听听
By听identifying听optimal听dosing, limiting unnecessary exposure, and using rapid diagnostics to target therapy, we can treat infections effectively while preserving the usefulness of antibiotics. Stewardship is not about restricting care; it is about using antibiotics wisely and听precisely听so they continue to work for the next patient who needs them.听
What needs to change going forward?
We need to modernize how we discover, evaluate, and use antibiotics. This听means developing new drugs and听diagnostics but also making smarter use of the ones we already have. Clinically, we must embrace individualized dosing, integrate real-time data into care decisions, and expand stewardship programs across health-care systems.听听
On the policy side, we need sustained investment in research,听surveillance听and public health infrastructure. If we bring science,听policy听and clinical practice together, we can preserve the power of antibiotics and ensure that serious infections听remain听treatable for generations to come.
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