Exposed: Dutch and London clinical microbiologists

Six weeks ago I blogged on the exposure of Dutch clinical microbiologists by Marcel Levi, former boss of the Academic Medical Center in Amsterdam and now leading 5 academic centers in London. Apart from describing his new “totally resistance-free” work situation, he criticized  the microbiologists in both countries for “not attempting to change the money-wasting and empty-brain practice of microbiological diagnostics”. Unfortunately, Marcel Levi is not just “another person” with an opinion. So, here are four suggestions to change his opinion, before all microbiologists have been sacked. Continue reading

On the effects of antibiotic stewardship: I met a analysis

Yet another meta-analysis telling us that we are doing something very valuable: antibiotic stewardship (AS). Nobody wants to (or should) question that good AS is important for our patients, just as hand hygiene, being sober when working and following the latest professional developments. How nice would it be if we could reliably quantify the effects of our good practice. One study is no study (say those that usually don’t perform studies), so the meta-analysis was invented. But what is told by a meta-analysis? Continue reading

The Extended Study on Prevalence of Infection in Intensive Care (EPIC III)

On the World Sepsis Day, September 13, 2017, The Extended Study on Prevalence of Infection in Intensive Care (EPIC III) will be performed. EPIC III  is a 24-hour point-prevalence study that will collect data on demographics, infection management, degree of organ dysfunction and patient outcomes in ICUs around the world. The EPIC study was performed in 1992 and EPIC II in 2007. Every ICU can join the project and participation will provide a nice opportunity for data comparison between ICUs, countries and continents.

EPIC III will be observational and non-interventional, and patient data will be anonymous. Data collection will be limited to simple variables that are easy to collect and routinely recorded. Data will be recorded using electronic case report forms (eCRF) (paper versions can be provided if online access is problematic or not available). In each country a coordinating center has obtained ethical approval fort he study, and participation will, therefore, only require informing your ethical committee according to local requirements.

The first EPIC study (the E stood for European) was performed in 1,417 ICUs in 17 countries in Western Europe that enrolled 10,038 patients. The EPIC II study (with the E from Extended) had 13,796 adult patients in 1,265 participating ICUs from 75 countries on the study day. Interested? Contact the study team at this page.

Effective stewardship: less antibiotic use and more hand hygiene

Rossana Rosa (bio below) writes a guest post, reflecting on this recent review and meta-analysis on the effectiveness of antimicrobial stewardship (AMS) programmes…

The first reports on the effects of Antimicrobial Stewardship Programmess date back to the mid-90s, and the interest in them has taken off in the past decade.

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Looking back on a CPE plasmid attack in the Northwest of England

A genomic study of 44 isolates of CPE from various species identified between 2008 and 2010, mainly from the Northwest of England, has concluded that plasmids played a key role in the early dissemination of CPE.

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The antibiotic course has had its day? (part 2)

British colleagues found no scientific evidence for “completing your course of antibiotics”. Nothing new, but in the absence of competing news (the White House has become a daily soap) they opened Pandoras’ box for the lay press, with patients being recommended to stop their antibiotics, whenever they want. The birth of yet another inconvenient truth, as we cannot translate our knowledge into daily medical practice, and patients get even more confused. The good news: a new research agenda. Continue reading

A health economist’s guide to the AMS galaxy

Guest blogger Nikki Naylor (bio below) has written this post about a recent review on the cost-effectiveness of antimicrobial stewardship…

I’ll start this blog post off with a promise – I promise not to use any equations or unnecessarily complex terms that just describe logical concepts (something us economists do like to do on occasion). In return, I hope that you will see past the standard and not-to-exhilarating conclusion of “more evidence is needed” and see some of the more useful messages that sit within this recent review that we have published.

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