Meet the Expert: Gauri Rao

Dr. Rao is leading the charge against the growing threat of drug-resistant “superbugs”

Story by Ryan McDaniel | Published August 1, 2023

Imagine you enter the hospital for an elective, outpatient surgery. Everything goes according to plan, and you are discharged to go home for your rest and recovery. But a few days later you develop a cough, fever, chills, and other flu-like symptoms. Lab tests reveal that you have pneumonia due to hospital-acquired Klebsiella pneumoniae. Worse yet, this particular strain of Klebsiella is multi-drug resistant. You are battling a ‘superbug.’

Superbugs are bacteria that are resistant to multiple antibiotics, complicating treatment and growing as a global threat. As of 2019, the Centers for Disease Control and Prevention estimated 35,000 deaths from superbugs in the US alone. The drugs that have helped us battle infection for nearly a century are now no longer able to keep up with some of the bacteria that threaten our health.

Enter Dr. Gauri Rao, PharmD, MS, Associate Professor in the Division of Pharmacotherapy and Experimental Therapeutics (DPET). Since her PharmD clinical rotations, Gauri has been aware of the growing problem of superbugs and has been working to counter it. “The antibiotic drug pipeline continues to shrink, making the treatment of infections due to these resistant bacteria very challenging,” she explains. “Combined with the continued pace of emergence of these resistant pathogens, that has put emphasis on optimizing the use of existing drugs.”

Gauri’s research aims to create effective drug regimens of both antibiotics and non-antibiotic drugs to help patients fighting superbugs. Her lab applies systems pharmacology combined with pharmacokinetics/pharmacodynamics (PK/PD) to increase treatment efficacy. Her work spans both translation as well as discovery. “[Our lab] explores opportunities to translate effective antibiotic regimens that have shown very promising activity in our in vitro as well as in vivo models of infection,” she describes. “We are also in the process of patenting two new drug molecules that have shown excellent activity against highly resistant bacteria like carbapenemase producing Enterobacteriaceae (CRE).”

Those most familiar with Gauri’s work recognize its potential for impact. “Her research has enabled her to develop a nationally recognized, externally-funded, and very productive research program,” observes Daniel Weiner, PhD, Adjunct Professor in DPET. “Initially developed to combat antibiotic-resistant infections, her research program is working to extend this platform to cystic fibrosis, tuberculosis, and burn patients.”

Robert Bonomo, MD, a Professor in the School of Medicine at Case Western Reserve University speaks to patient outcomes of Gauri’s research. “Her approach to difficult to treat (DTR) pathogens using both standard and non-conventional approaches will clearly yield better therapeutic options for physicians treating multi drug and extensively drug resistant infections,” he asserts.

While Gauri could be doing this research at many peer institutions, she was drawn to the UNC Eshelman School of Pharmacy by the vision of School leadership and the collaborative nature apparent to UNC. “Former Dean Blouin and now Dean Angela Kashuba were very interested in developing UNC’s expertise in Pharmacometrics and in continuing to grow the research capabilities at the school,” she reflects. “The culture at the School as well as UNC is highly collaborative and access to expertise and resources to expand my research has been very easy. Researchers within the School and the University are eager to share their knowledge, resources and expertise.”

Outside of her work, Gauri’s natural curiosity manifests in a desire to explore. She likes to travel, getting to know the world a little better through her taste buds. “One of the reasons I enjoy being in academia is the perk of traveling to new places. I enjoy travelling and exploring cafes for excellent coffee,” she says. She also enjoys running and seeking out new trails around the Triangle.

Being in the Triangle has also helped Gauri’s research. She has found collaborators at RTI International and been able to leverage resources from NC TraCS Institute. She cites these, as well as access to mentorship at UNC and at the School as key factors to help her research success.

With the growing prevalence of superbugs, research like Gauri’s is crucial to ensure the best patient outcomes today and in the future. As Robert Bonomo affirms, Gauri is well-poised to take this issue on: “In her hands, I am certain that a drug can be appropriately characterized and the necessary knowledge to deliver effective therapy with that agent will be uncovered. I can think of no other pharmacologist that I’ve worked with over the past few years that has this unique ability and talent.”