CRE RESPOND has reached an important milestone with the launch of the ROAD RCT (Resistant‑Optimised Antimicrobial Dosing in Critically Ill Patients)—a randomised clinical trial that places the Centre at the forefront of global efforts to tackle antimicrobial resistance in intensive care.
Funded by the Australian Government’s Medical Research Future Fund (MRFF), the ROAD RCT is the first multi-continent randomised controlled trial to test whether resistance‑optimised, precision dosing of antibiotics can improve outcomes for critically ill patients. The trial brings together international partners to address a long‑standing problem in critical care: standard antibiotic doses often fail to account for the profound physiological changes seen in ICU patients, increasing the risk of both treatment failure and antimicrobial resistance.
ROAD RCT will enrol 610 adult participants with severe respiratory infections across multiple ICUs. Participants will be randomised to receive either model‑informed, resistance‑optimised dosing or standard care dosing of piperacillin/tazobactam or meropenem, two of the most widely used beta‑lactam antibiotics in critical care. The primary outcome is clinical cure at Day 14, supported by a broad set of secondary outcomes covering patient survival, adverse events, organ support, length of stay, and health‑economic impact.
A key strength of the study is its integration of pharmacokinetic and pharmacodynamic monitoring, therapeutic drug monitoring, and genomic analyses. This allows the team to track how dosing strategies influence drug exposure, clinical response, and the emergence of antimicrobial resistance over time.
Together, these elements make ROAD RCT a defining achievement for CRE RESPOND—combining strong clinical relevance with rigorous science to generate evidence that has the potential to change ICU practice worldwide.
