Integrative Biomedical Research

Integrative Biomedical Research (Journal of Angiotherapy) | Online ISSN  3068-6326
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From Days to Hours: Artificial Intelligence in Antimicrobial Resistance Diagnostics and Drug Discovery, and Why No Tool Has Yet Reached the Clinic

Abstract References

Nahid Amin1*, Papiya Sultana Sharker Sharna1

+ Author Affiliations

Integrative Biomedical Research 10 (1) 1-8 https://doi.org/10.25163/biomedical.10110890

Submitted: 22 June 2026 Revised: 02 September 2026  Accepted: 07 September 2026  Published: 09 September 2026 


Abstract

Background: Antimicrobial resistance (AMR) is projected to contribute to millions of deaths in the coming decades, and the conventional antibiotic-discovery pipeline has, by most accounts, not kept pace with it. Artificial intelligence (AI) is frequently proposed as a corrective, though whether that promise has translated into demonstrable clinical benefit is less often examined directly.

Methods: We conducted a narrative-systematic review of peer-reviewed and preprint literature on AI applications in AMR diagnostics and antimicrobial discovery, searching PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library through mid-2026, and organized findings across four domains: rapid phenotypic diagnostics, genomic and metagenomic resistome prediction, explainable AI, and de novo drug design.

Results: AI-enabled diagnostics reduced susceptibility-testing turnaround from a conventional 36–72 hours to under 2–4 hours in several platforms; genomic language models such as DNABERT outperformed conventional classifiers by 12–18% in resistance-gene classification; explainable AI methods, SHAP in particular, linked model predictions to known resistance mechanisms; and generative frameworks yielded antimicrobial peptide candidates with confirmed in vitro and in vivo activity. Nearly all of this evidence, however, derives from retrospective, single-center validation, and no AI-based AMR tool has yet secured regulatory clearance anywhere.

Conclusion: AI has moved convincingly beyond proof-of-concept in AMR diagnostics and discovery, but its path to the clinic now depends less on further algorithmic refinement than on prospective validation, equitable data representation, and interpretability standards that clinicians can reasonably trust.

Keywords: antimicrobial resistance; artificial intelligence; explainable AI; whole-genome sequencing; clinical translation

References

Abdul Ghafur, A., Nagao, M., Kanj, S. S., Abbara, S., Tattevin, P., Awad, M., Dagher, M., Ndegwa, L. K., Mundia, G., Schouten, J., Vu, H. T. L., Hara, G. L., Satyaseela, M. P., Aldeyab, M. A., Bhat, R. K., Bansal, N., & Wertheim, H. F. (2026). Artificial intelligence and antimicrobial stewardship: From clinical decision support to public health action. Journal of Global Antimicrobial Resistance, 28, 1–15. https://doi.org/10.1016/j.jgar.2026.08.003

Abdulrazaq, I., Elelu, S.-A., Ibrahim, G. O., Temitope, I. A., Avoswahi, A. H., Zakari, A. T., & Abdulsalam, M. (2025). Advancements in microbial drug discovery: Leveraging AI, CRISPR, and microbiome insights to overcome antimicrobial resistance. Biological Sciences, 1, 1–15. https://doi.org/10.55006/biolsciences.2025.5304

Abo-Tbeak, Z. J., & AL-Hilali, R. H. (2026). Artificial intelligence in microbiology: Applications in microbial data analysis and drug discovery. World of Medicine: Journal of Biomedical Sciences, 3(5), 45–52.

Aggarwal, R., Nagre, S., & Wardell, S. J. (2026). Artificial intelligence for antimicrobial resistance detection and prediction. Infection and Drug Resistance, 19, 614–240. https://doi.org/10.2147/IDR.S614240

Ahmed, N., & Alghamdi, M. (2026). Role of artificial intelligence in infectious diseases and antimicrobial resistance: A comprehensive review on diagnostic, treatment, and prevention aspects. Saudi Medical Journal, 47(2), 219–237. https://doi.org/10.15537/1658-3175.1003

Alatawi, A. D., Hetta, H. F., Ali, M. A. S., Ramadan, Y. N., Alaqyli, A. B., Alansari, W. K., Aldhaheri, N. H., Bin Selim, T. A., Merdad, S. A., Alharbi, M. O., Alatawi, W. A. H., & Algammal, A. M. (2025). Diagnostic innovations to combat antibiotic resistance in critical care: Tools for targeted therapy and stewardship. Diagnostics, 15, 2244. https://doi.org/10.3390/diagnostics15172244

Antonie, N. I., Gheorghe, G., Ionescu, V. A., Tiuca, L. C., & Diaconu, C. C. (2025). The role of ChatGPT and AI chatbots in optimizing antibiotic therapy: A comprehensive narrative review. Antibiotics, 14(1), 60. https://doi.org/10.3390/antibiotics14010060

Arango-Argoty, G., Garner, E., Pruden, A., Heath, L. S., Vikesland, P., & Zhang, L. (2018). DeepARG: A deep learning approach for predicting antibiotic resistance genes from metagenomic data. Microbiome, 6(1), 23. https://doi.org/10.1186/s40168-018-0401-z

Avershina, E., Sharma, P., Taxt, A. M., Singh, H., Frye, S. A., Paul, K., Kapil, A., Naseer, U., Kaur, P., & Ahmad, R. (2021). AMR-Diag: Neural network based genotype-to-phenotype prediction of resistance towards β-lactams in Escherichia coli and Klebsiella pneumoniae. Computational and Structural Biotechnology Journal, 19, 1896–1906. https://doi.org/10.1016/j.csbj.2021.03.027

Awan, R. E., Zainab, S., Yousuf, F. J., & Mughal, S. (2024). AI-driven drug discovery: Exploring Abaucin as a promising treatment against multidrug-resistant Acinetobacter baumannii. Health Science Reports, 7, e2150. https://doi.org/10.1002/hsr2.2150

Bhattacharjee, S., & Bhattacharya, S. (2025). Leveraging AI-driven nudge theory to enhance hand hygiene compliance: Paving the path for future infection control. Frontiers in Public Health, 12, 1522045. https://doi.org/10.3389/fpubh.2024.1522045

Bhattacharya, R., Bose, D., Rodriguez, R. V., Kaur, T., & Pillai, M. (2026). A One Health plan to combat antimicrobial resistance for improving global health through sustainable development. Discover Public Health, 23(10), 1–17. https://doi.org/10.1186/s12982-025-01302-1

Branda, F., & Scarpa, F. (2024). Implications of artificial intelligence in addressing antimicrobial resistance: Innovations, global challenges, and healthcare’s future. Antibiotics, 13(6), 502. https://doi.org/10.3390/antibiotics13060502

Chines, E., Tempesta, A. A., Boscarelli, L., Parisi, M. F., Marcoccia, L., Capillo, A., Mezzatesta, M. L., Ledda, C., Chessari, M., & Cafiso, V. (2026). Next-generation target discovery in ESKAPE pathogens: An AI-driven framework from omics-based to systems-level modeling and clinical translation. Antibiotics, 15(5), 469. https://doi.org/10.3390/antibiotics15050469

Collins, G. S., Reitsma, J. B., Altman, D. G., & Moons, K. G. M. (2015). Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): The TRIPOD statement. BMJ, 350, g7594. https://doi.org/10.1136/bmj.g7594

Davis, J. J., Boisvert, S., Brettin, T., Kenyon, R. W., Mao, C., Olson, R., Overbeek, R., Santerre, J., Shukla, M., Wattam, A. R., Will, R., Xia, F., & Stevens, R. (2016). Antimicrobial resistance prediction in PATRIC and RAST. Scientific Reports, 6, 27930. https://doi.org/10.1038/srep27930

Drouin, A., Letarte, G., Raymond, F., Marchand, M., Corbeil, J., & Laviolette, F. (2019). Interpretable genotype-to-phenotype classifiers with performance guarantees. Scientific Reports, 9, 4071. https://doi.org/10.1038/s41598-019-40561-2

Hassan, M., Ali, R., & Zughaier, S. M. (2026). Role of artificial intelligence in bacterial diagnostics, surveillance, and clinical decision support. Digital Health, 12, 1–13.

Hudu, S. A., Alshrari, A. S., Abu-Shoura, E. J. I., Osman, A., & Jimoh, A. O. (2025). A critical review of the prospect of integrating artificial intelligence in infectious disease diagnosis and prognosis. Interdisciplinary Perspectives on Infectious Diseases, 2025, 6816002. https://doi.org/10.1155/2025/6816002

Hyun, J. C., Kavvas, E. S., Monk, J. M., & Palsson, B. O. (2020). Machine learning with random subspace ensembles identifies antimicrobial resistance determinants from pan-genomes of three pathogens. PLoS Computational Biology, 16, e1007608. https://doi.org/10.1371/journal.pcbi.1007608

Jha, A., Aicher, J. K., Gazzara, M. R., Singh, D., & Barash, Y. (2020). Enhanced integrated gradients: Improving interpretability of deep learning models using splicing codes as a case study. Genome Biology, 21, 149. https://doi.org/10.1186/s13059-020-02055-7

Jia, H., Li, X., Zhuang, Y., Wu, Y., Shi, S., Sun, Q., He, F., Liang, S., Wang, J., & Draz, M. S. (2024). Neural network-based predictions of antimicrobial resistance phenotypes in multidrug-resistant Acinetobacter baumannii from whole genome sequencing and gene expression. Antimicrobial Agents and Chemotherapy, 68, e01446-24. https://doi.org/10.1128/aac.01446-24

Kasse, G. E., Cosh, S. M., Humphries, J., & Islam, M. S. (2025). Leveraging artificial intelligence for One Health: Opportunities and challenges in tackling antimicrobial resistance—A scoping review. One Health Outlook, 7(1), 51. https://doi.org/10.1186/s42522-025-00170-8

Khangarot, R., Kumari, V., Mishra, R., & Singh, A. (2026). Artificial intelligence in microbiology: Implications for metagenomics, diagnostics, and AMR surveillance. BioMed Engineering OnLine, 25, 1–18. https://doi.org/10.1186/s12938-026-01568-9

Kim, J. I., Manuele, A., Maguire, F., Zaheer, R., McAllister, T. A., & Beiko, R. G. (2024). Identification of key drivers of antimicrobial resistance in Enterococcus using machine learning. Canadian Journal of Microbiology, 70, 446–460. https://doi.org/10.1139/cjm-2024-0012

Kula, C., Erguven, I., Ozcelik, B., Gulfidan, G., & Arga, K. Y. (2026). Transcriptome-based machine learning models to predict antimicrobial resistance in Pseudomonas aeruginosa. OMICS: A Journal of Integrative Biology, 30, 94–104. https://doi.org/10.1089/omi.2026.0022

Lee, H., Lee, S., & Lee, I. (2023). AMP-BERT: Prediction of antimicrobial peptide function based on a BERT model. Protein Science, 32, e4529. https://doi.org/10.1002/pro.4529

Liao, H., Xie, L., Zhang, N., Lu, J., & Zhang, J. (2025). Advancements in AI-driven drug sensitivity testing research. Frontiers in Cellular and Infection Microbiology, 15, 1560569. https://doi.org/10.3389/fcimb.2025.1560569

Lundberg, S. M., & Lee, S.-I. (2017). A unified approach to interpreting model predictions. Advances in Neural Information Processing Systems, 30.

Maldonado-Hernández, R., Ortiz-Gómez, V., Flores-González, A., Meléndez-Delgado, J., Meléndez-González, H., & Wu-Mo, C. (2026). Artificial intelligence-driven discovery and optimization of antimicrobial peptides targeting ESKAPE pathogens and multidrug-resistant fungi. Microorganisms, 14, 591. https://doi.org/10.3390/microorganisms14030591

Mohammed, A. M., Mohammed, M., Oleiwi, J. K., Osman, A. F., Adam, T., Betar, B. O., Gopinath, S. C. B., & Ihmedee, F. H. (2025). Enhancing antimicrobial resistance strategies leveraging artificial intelligence: Opportunities, challenges, and future prospects. South African Journal of Chemical Engineering, 51, 272–286. https://doi.org/10.1016/j.sajce.2024.12.005

Moradigaravand, D., Palm, M., Farewell, A., Mustonen, V., Warringer, J., & Parts, L. (2018). Prediction of antibiotic resistance in Escherichia coli from large-scale pan-genome data. PLoS Computational Biology, 14, e1006258. https://doi.org/10.1371/journal.pcbi.1006258

Murray, C. J. L., Ikuta, K. S., Sharara, F., Swetschinski, L., Robles Aguilar, G., Gray, A., Han, C., Bisignano, C., Rao, P., Wool, E., Johnson, S. C., Browne, A. J., Chipeta, M. G., Fell, F., Hackett, S., Haines-Woodhouse, G., Kashef Hamadani, B. H., Kumaran, E. A. P., McManigal, B., … Naghavi, M. (2022). Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. The Lancet, 399(10325), 629–655. https://doi.org/10.1016/S0140-6736(21)02724-0

Nagre, S., Dole, V., Kharat, A., Kharat, R., Musadwale, S., Solanke, P., Sonone, R., & Nagrik, S. (2025). Artificial intelligence in infectious disease pharmacology: Transforming drug discovery, precision therapy, and global health. International Journal of Scientific Research and Technology, 2(9), 1–12.

Nguyen, M., Long, S. W., McDermott, P. F., Davis, J. J., Olsen, R. J., Sanderson, R., & Butler, J. E. (2019). Using machine learning to predict antimicrobial MICs and associated genomic features for nontyphoidal Salmonella. Journal of Clinical Microbiology, 57, 1–15. https://doi.org/10.1128/JCM.01260-18

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71

Rahman, M. S., & Wakeman, C. A. (2026). Antibiotic resistance in Pseudomonas aeruginosa: Mechanisms, diagnostic challenges, and omics-based diagnostic solutions. Frontiers in Microbiology, 17, 1791577. https://doi.org/10.3389/fmicb.2026.1791577

Rahman, M. U., Shah, J. A., Khan, M. N., Bilal, H., Zhu, D., Du, Z., & Mu, D.-S. (2025). Innovative approaches to combat antimicrobial resistance: A review of emerging therapies and technologies. Probiotics and Antimicrobial Proteins. https://doi.org/10.1007/s12602-025-10676-2

Rahman, S. Z., Senthil, R., Ramalingam, V., & Gopal, R. (2023). Predicting infectious disease outbreaks with machine learning and epidemiological data. Journal of Advanced Zoology, 44, 110–121.

Ribeiro, M. T., Singh, S., & Guestrin, C. (2016). “Why should I trust you?”: Explaining the predictions of any classifier. Proceedings of the 22nd ACM SIGKDD International Conference on Knowledge Discovery and Data Mining, 1135–1144. https://doi.org/10.1145/2939672.2939778

Salama, R. A., Nagre, S., Dole, V., Kharat, A., Kharat, R., Musadwale, S., Solanke, P., Sonone, R., & Nagrik, S. (2026). Artificial intelligence in infectious disease pharmacology: Transforming drug discovery, precision therapy, and global health. Infection Prevention in Practice, 8, 100522. https://doi.org/10.1016/j.infpip.2026.100522

Sanapalli, B. K. R., Palit, S., Deshpande, A., Tokala, R., Sigalapalli, D. K., & Sanapalli, V. (2026). Artificial intelligence and the discovery of antibiotics: Reinventing with opportunities, challenges, and clinical translation. Antibiotics, 15, 233. https://doi.org/10.3390/antibiotics15020233

Scaglione, G., Mastroianni, N., Rizzo, A., Palomba, E., Carcione, D., Rimoldi, S. G., Brigante, G., Principe, L., Colaneri, M., Gori, A., & Borgonovo, F. (2026). Integrating artificial intelligence with genome sequencing against antimicrobial resistance: A narrative review. Frontiers in Public Health, 14, 1757161. https://doi.org/10.3389/fpubh.2026.1757161

Sardar, S., Dash, S., Roychowdhury, P., Solanki, J., Sikdar, P., Thangappan, J., & Dutta, S. (2026). Artificial intelligence for antimicrobial resistance: Advancing reproducibility, interpretability, and clinical deployment. Briefings in Bioinformatics, 27, bbag269. https://doi.org/10.1093/bib/bbag269

Stokes, J. M., Yang, K., Swanson, K., Jin, W., Cubillos-Ruiz, A., Donghia, N. M., MacNair, C. R., French, S., Carfrae, L. A., Bloom-Ackermann, Z., Tran, V. M., Chiappino-Pepe, A., Badran, A. H., Andrews, I. W., Chory, E. J., Church, G. M., Brown, E. D., Jaakkola, T. S., Barzilay, R., & Collins, J. J. (2020). A deep learning approach to antibiotic discovery. Cell, 180(4), 688–702.e13. https://doi.org/10.1016/j.cell.2020.01.021

Wolff, R. F., Moons, K. G. M., Riley, R. D., Whiting, P. F., Westwood, M., Collins, G. S., Reitsma, J. B., Kleijnen, J., & Mallett, S. (2019). PROBAST: A tool to assess the risk of bias and applicability of prediction model studies. Annals of Internal Medicine, 170(1), 51–58. https://doi.org/10.7326/M18-1376

Wong, F., Zheng, E. J., Valeri, J. A., Donghia, N. M., Anahtar, M. N., Omori, S., Li, A., Cubillos-Ruiz, A., Krishnan, A., Jin, W., Manson, A. L., Friedrichs, J., Helbig, R., Hajian, B., Fiejtek, D. K., Wagner, F. F., Soutter, H. H., Earl, A. M., Stokes, J. M., … Collins, J. J. (2024). Discovery of a structural class of antibiotics with explainable deep learning. Nature, 626, 177–185. https://doi.org/10.1038/s41586-023-06887-8

Wu-Mo, C., Flores-González, A., Meléndez-Delgado, J., Ortiz-Gómez, V., Meléndez-González, H., & Maldonado-Hernández, R. (2026). Artificial intelligence-driven discovery and optimization of antimicrobial peptides targeting ESKAPE pathogens and multidrug-resistant fungi. Microorganisms, 14, 591. https://doi.org/10.3390/microorganisms14030591


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