Medpace Experts Share Highlights from ESCMID Global
In April 2026, Medpace infectious diseases and vaccines experts attended ESCMID Global in Munich, Germany. As one of the most prominent international congresses in infectious diseases and clinical microbiology, this five-day meeting brought together leading scientists, clinicians, and industry partners from around the world. This year’s program reflected on major clinical trial results and changes in guidelines from the past year, while also addressing a broad spectrum of high-impact topics, including antimicrobial resistance (AMR), respiratory viruses, and sepsis.
Explore perspectives from Medpace medical and operational experts as they highlight several of the key themes emerging from ESCMID Global 2026.
Key Conference Takeaways
Pipeline Innovation: Targeted AMR + Diversification of Modalities
One of the most important insights from ESCMID’s industry updates is that the pipeline is evolving in two directions simultaneously:
- Targeted AMR – Increasingly targeted (precision AMR focus)
- Nacubactam (Meiji): nacubactam/cefepime for serine-carbapenemase-producing isolates and nacubacam/aztreonam for metallo-β-lactamase (MBL)-producers. Meiji’s data further reinforced the continued importance of strong Phase III datasets, PK/PD-driven development, and flexible regulatory pathways.
- Wockhardt: zidebactam/cefepime has high activity against NDM-producing E. coli with PBP3 insertion mutants
- Bioversys BV100: carbapenem-resistant Acinetobacter
- Fedora FPI-2119: resistant Gram-negative infections
- Bacteriophages alone and in combination with traditional antibiotics or even in combination with immune-modulating drugs such as methotrexate as adjunctive anti-infective strategies.
- Diversification – Industry presentations reinforced two parallel trends: continued focus on resistant pathogens and expansion into new therapeutic modalities.
- Programs targeting drug resistant Gram-negative pathogens remain central (e.g., Fedora’s FPI-2119 showing activity across multiple resistant pathogens and infection types, including cUTI and pneumonia).
- Reemergence of older antibiotics, like temocillin, including their potential advantages (e.g., non-inferiority compared to carbapenems and superiority to cephalosporins in preserving intestinal microbiota in some indications)
- Immune-based therapies (e.g., bispecific antibodies)
- Eradivir presented EV25 clinical data from a human influenza A/H3N2 challenge study showing single-dose efficacy, reduced viral load, and symptom improvement. EV25 is pharmacologically different from traditional antivirals and is closer to immunotherapy than classical pharmacology; it does not inhibit viral replication directly but is a bifunctional antibody-recruiting molecule that binds to infected cells and recruits pre-existing antibodies to clear them. The mechanism is viral agnostic, and the same platform is being applied to RSV and other respiratory viruses.
- Broad-spectrum antivirals: moving beyond single-virus drugs to platform agents active across multiple viruses or even viral families.
- For example, Model Medicines presented MDL-001 which targets multiple viruses and viral families, including influenza, RSV, SARS-CoV-2, and hepatitis viruses. MDL-001 was identified using AI-based drug discovery platforms.
- Vaccines and monoclonal antibodies: Vaccines are now discussed alongside therapeutics, diagnostics, and AI—not separately.
- AMR-driven vaccine strategy. Companies like Vaxdyn presented data on strategies to address Gram-negative bacterial pathogens with potential high resistance burdens with a focus on at-risk populations.
- Longhorn Vaccines and Diagnostics continued with the shift toward broader protection and presented data on a novel bispecific IgM monoclonal antibody with broad antibacterial activity against Gram positives, Gram negatives, and mycobacteria, an exciting potential immunotherapeutic.
- Drug delivery as the therapeutic modality
- Fascinating data from Oxford University about vancomycin-load “microbubbles” and ultrasound to disrupt biofilms and enhance penetration of the antibiotic at the site of infection, potentially useful in treating organisms resistant to traditional antibiotics.
Companies are no longer choosing between “broad vs. targeted”. They are building pipelines that include both approaches, often within the same portfolio.
Importance of Screening for MDR Pathogens, including fungi (e.g., Candida auris)
Evidence supporting rectal screening was shown, including laboratory methods and their implications in:
- Infection control practices
- Perioperative prophylaxis based on rectal screening
- Treatment empiric algorithms in severe infections
- Utility in immunocompromised patients (hematologic and solid organ transplantation)
Sepsis
Sepsis, a life-threatening organ dysfunction caused by infection, is still a global health priority. The updated Surviving Sepsis Campaign (SSC) guidelines were presented, with a focus on real-world implications, followed by the latest progress in immunotherapy to improve outcomes. The SSC guidelines are intended to support clinicians caring for adult patients with sepsis, focusing on management in the hospital, the immediate prehospital setting, and the immediate post-hospital setting. Presented guidelines incorporate principles of antimicrobial stewardship through responsible antimicrobial use, proper diagnostic strategies, and de-escalation of antimicrobial therapy.
A presentation related to Immunotherapy for sepsis introduced the new hope that we may finally see the meaningful and measurable benefit for patients with specific sepsis endo/phenotypes. The presentation focused on the mechanism of immunoparalysis and macrophage activation-like syndrome and the results of studies targeting immunoparalysis (GRID; PREV-HAP), as well as studies targeting both mechanisms (PROVIDE and IMMUNOSEP). The IMMUNOSEP study met its primary endpoint by attainment of >1.4-point decrease of a mean SOFA score in the precision therapy arm, which is a good base for the upcoming phase 2b/3 study. The presenter also introduced the Interferon –Gamma derived sepsis (IDS) endotype and discussed the results of the EMBRACE study indicating improvement in patients receiving high dose emapalumab organ function, lower 28-day mortality and faster reduction of proinflammatory biomarkers linked to INF Gamma signaling vs. placebo.
These encouraging results confirmed the concept of sepsis being a complex syndrome with different biological drivers as well as the need to step down from “one size fits all” concept in sepsis research and focus on precision treatment targeting specific sepsis endotypes.
Potential Regulatory Re-Classification of Complicated Urinary Tract Infections (cUTIs) in the Near Future
From a European perspective, a different classification of UTIs should be developed, and this position is strongly supported by many key opinion leaders. For example, there is debate whether cUTI should be changed to UTI with systemic involvement. Clearly, if the definitions are changed, harmonization between regulatory agencies will be highly desirable, including risk factors and the non-inferiority margin.
Note: Currently, the two leading regulatory agencies (FDA and EMA) are sustaining their definitions.
Artificial Intelligence (AI)
AI continued to be widely represented at ESCMID Global 2026 across drug discovery, diagnostics, adaptive platform trial designs (REMAP-CAP, SNAP), and regulatory (EMA). Still, there was a lot of discussion and perspectives from academia, regulators, and industry highlighting variability in performance, data quality challenges, and regulatory requirements for transparency and validation. The EMA did share that there is some precedent for AI-generated control groups, while underscoring the need for continuous monitoring, updating, and reassessing over time. Clear and accessible documentation of the tools and processes remains a requirement.
The opportunity to utilize tools such as AI to improve adaptive and data-rich clinical development is critical as infectious diseases drug development has often been slowed by fragmented datasets and difficult trial recruitment. Other utilizations in platform trials and reusable data infrastructures are becoming part of the innovation stack, not just a methodological side topic.
Innovation alone is not enough. Without regulatory and access frameworks that fully recognize the value of these tools in addressing AMR, their impact will remain limited.
Market Access
ESCMID Global 2026 placed unusual emphasis on market access. Several discussions focused on addressing the current gaps between science and policy with lessons from EU HTA regulation and vaccines.
Global AMR leaders from CARB-X, LifeArc, and the Gates Foundation were present, underscoring that the bottleneck for drug development includes policy and funding opportunities. For drug developers, this is one of the most important messages of ESCMID Global 2026: the field is trying to fix the “approval but no viable market” problem in parallel with improving science.
Partnership was emphasized as instrumental for funding the development of new agents targeting AMR, including the need for “partnership with the partnership”. Key drivers supporting partnership:
- Risk sharing across the R&D to access continuum
- Continuity across political and funding cycles
- Alignment among discovery, development, and delivery actors
- Complementary expertise
- Collaborative and complimentary ways of working to enhance efficiency and innovation
Technology Signals: Diagnostics
Shorter turnaround times and operational scalability were common themes from many diagnostic companies. Bruker described work on same-day phenotype antimicrobial susceptibility tests from positive blood cultures and colonies, AI-driven antibiotic resistance prediction from MALDI spectra, expanded MALDI libraries, outbreak tools, and MALDI/IR-triggered reflex WGS workflows.
Other technologies with one-pot RPA-CRISPR/Cas12a platforms for rapid carbapenemase detection, metagenomic approaches in outbreak investigations, and an ultrasensitive plasmon-enhanced lateral flow assay for N. gonorrhea may not have been headline plenaries but are strong indications of where enabling technologies are moving. These technologies point toward faster resistance detections, culture-independent investigations, more sensitive decentralized testing, and a move away from single-purpose instruments to connected phenotypic-genotypic decision systems.
As we reflect on the latest trends in ID&V clinical development, we are equally focused on what comes next—preparing for the next wave of innovation shaping this rapidly evolving field. Emerging technologies, scientific advancements, and a growing ID&V development pipeline are creating new opportunities to advance global health.
Unable to connect with us during ESCMID Global? We welcome the opportunity to collaborate. Contact our ID&V experts to discuss how Medpace can support your clinical development strategy.
A Leading Global CRO for Infectious Diseases & Vaccines
Medpace’s specialized cross-functional team of experts have extensive experience executing global trials in antivirals, antibacterials, antifungals, vaccines, and immunotherapies spanning adult and pediatric patients, as well as special at-risk populations. Our experienced medical leadership team, integrated laboratories and clinical trial management system, and extensive site and investigator relationships produce a truly seamless drug development process.
In the past 9 years, Medpace ID&V experts have contributed to:
83%
of antibacterial
FDA approvals
66%
of antifungal
FDA approvals
20%
of antiviral
FDA approvals
16%
of antiparasitic
FDA approvals
14%
of vaccine
FDA approvals
