Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Oct 6:S1473-3099(25)00501-8.
doi: 10.1016/S1473-3099(25)00501-8. Online ahead of print.

The Emerging Resistance Index: tracking early resistance to new antibiotics

Jacopo Garlasco  1 , Fabiana Arieti  1 , Matteo Morra  1 , Maela Tebon  1 , Diego Ortiz  2 , Maria Diletta Pezzani  1 , Karin Odoj  2 , Federica Manco  1 , Alessandro Cassini  3 , Stephan Harbarth  4 , Elisabeth Presterl  5 , Biljana Carevic  6 , Gunnar Kahlmeter  7 , Karin Thursky  8 , Paola Morelli  9 , Stefan Hagel  10 , Alessia Savoldi  1 , Evelina Tacconelli  11
Affiliations
Review

The Emerging Resistance Index: tracking early resistance to new antibiotics

Jacopo Garlasco et al. Lancet Infect Dis. .

Abstract

The high clinical burden of antimicrobial resistance (AMR) and the dwindling antibiotic pipeline demand standardised tools to monitor resistance development to new antibiotics. The Emerging Resistance Index (ERI) is a novel quantitative tool designed to track resistance to newly developed antibiotics. The ERI incorporates various parameters: AMR pooled proportions and trends, availability of AMR and antimicrobial consumption surveillance systems, time lag between antibiotic approval and resistance detection, and the average annual number of outbreaks caused by resistant strains. AMR and antimicrobial consumption data on 13 new antibiotics were extracted by reviewing the literature and the reports from 38 surveillance systems included in the European Clinical Research Alliance on Infectious Diseases-The Epidemiology Network central data repository, encompassing 27 EU countries, four European Free Trade Association countries, and the UK. Our analysis revealed rapid resistance development to all new Gram-negative-targeting antibiotics, with particularly high ERI values for imipenem-relebactam and cefiderocol. Combinations of old β-lactams with novel inhibitors were especially prone to rapid resistance development. The ERI could offer a quantitative and dynamic tool for monitoring resistance trends. Also, the ERI could support more timely surveillance efforts, inform antibiotic policy decisions, and aid in prioritising antibiotic research and development.

PubMed Disclaimer

Conflict of interest statement

Declaration of interests The Epidemiology Network (EPI-Net) is funded by the ECRAID-Base consortium. The ECRAID-Base EPI-Net project received funding from the EU's Horizon 2020 research and innovation programme (grant agreement: 965313). There was no direct involvement of the funding source in the design of the Review and in the publication process. SHage has received honoraria for lectures, presentations, and travel support from InfectoPharm, Pfizer, Philips, Advanz, Beckman Coulter, Thermo Fisher Scientific, Shionogi, Tillots, and Merck Sharp Dohme; and has participated in a monitoring or advisory board for Advanz, Shionogi, and Pfizer. SHar has received grants and contracts from the EU, Swiss National Science Foundation, Moderna, the University of Geneva, and University Hospital of Geneva. EP has been the Chair of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) study group on nosocomial infections. All other authors declare no competing interests.

LinkOut - more resources