National Institute For Infectious Diseases Lazzaro Spallanzani

At the National Institute For Infectious Diseases Lazzaro Spallanzani, researchers are advancing treatments for serious bacterial and fungal diseases such as tuberculosis, bloodstream infections caused by resistant Enterobacteriaceae, and chronic pulmonary aspergillosis. Trials aim to evaluate safety and effectiveness of host‑directed adjuncts, optimized antibiotic dosing, and new antifungal agents to improve patient outcomes.

• Adjunctive host‑directed therapy with cysteamine for pulmonary tuberculosis
• Comparative efficacy of olorofim versus standard amphotericin B for invasive aspergillosis
• Optimized high‑dose rifampicin regimen to reduce hepatotoxicity in TB patients
• Rezafungin treatment for chronic pulmonary aspergillosis with limited options
• Non‑inferiority trial of piperacillin‑tazobactam versus meropenem for cephalosporin‑resistant bacteremia

These studies involve a multidisciplinary team of seven investigators and reflect the institute’s commitment to tackling antimicrobial resistance and difficult‑to‑treat fungal infections.

The department focuses on disorders of immune regulation, including post‑acute COVID‑19 syndrome and long COVID. Clinical work evaluates immunomodulatory drugs such as anakinra and tozorakimab, and monitors immune recovery after monoclonal antibody therapy, with the goal of reducing persistent symptoms and improving quality of life.

• Anakinra for symptom relief in post‑COVID respiratory syndrome
• Tozorakimab added to standard care for severe viral lung infection
• Longitudinal assessment of humoral and cellular immunity after monoclonal antibody treatment
• Identification of biomarkers predicting response to immune‑modulating therapies
• Evaluation of host‑directed strategies to mitigate chronic inflammation in long COVID

The research leverages the institute’s expertise in immunology to develop therapies that target the underlying immune dysregulation driving these conditions.

Clinical investigations address acute and chronic lung conditions, notably COVID-19 pneumonia, severe viral lung infections, and respiratory forms of tuberculosis. The aim is to test novel antivirals, host‑targeted adjuncts, and optimized antimicrobial regimens to reduce mortality and improve pulmonary function.

• Cysteamine as adjunct therapy for hospitalized COVID‑19 pneumonia patients
• Host‑directed treatment with tozorakimab for viral lung infection requiring supplemental oxygen
• High‑dose rifampicin safety assessment in pulmonary tuberculosis
• Safety and efficacy of new antifungal agents for chronic pulmonary aspergillosis
• Patient‑reported outcome measures to evaluate respiratory quality of life during trials

These projects integrate pulmonology and infectious disease expertise to deliver comprehensive care for patients with complex respiratory infections.

The institute’s virology program targets chronic viral infections such as HIV, Hepatitis B, and Hepatitis D. Ongoing trials assess novel antiretroviral combinations, long‑acting injectable regimens, and antiviral nucleic‑acid therapies to achieve sustained viral suppression and simplify treatment.

• Switch to bictegravir/lenacapavir versus continued Biktarvy in virologically suppressed HIV patients
• Early switch to a two‑drug dolutegravir/lamivudine regimen after viral suppression
• Weekly oral GS‑1720/GS‑4182 fixed‑dose combination versus standard Biktarvy
• Long‑acting cabotegravir/rilpivirine administered every two months compared with oral ART
• Bepirovirsen therapy for HIV/HBV coinfected individuals
• BJT‑778 versus bulevirtide for chronic hepatitis D infection

With seven dedicated investigators, the site contributes valuable data to global efforts aimed at improving viral disease management and patient adherence.