Clinical trials that could change the management of severe multidrug-resistant Gram-negative infections

Current RCTs have enriched clinical management of severe Gram-negative infections by validating new agents and supporting more personalized, safer, and shorter treatments. Nevertheless, gaps persist regarding their generalizability to high-risk populations and real-world infections. Complementary pathogen-focused trials, adaptive designs, and observational studies are needed to expand the evidence base, also for treatment duration in MDR infections, combination regimens, and resistance development. Integrating trial data with clinical judgment remains essential in bridging the gap between trial conditions and bedside care in line with the principles of precision medicine.