No more antibiotics for animals

That’s what the WHO stated this week, and it was based on a study, in Lancet Planetary Health. In most news items that I saw animal antibiotic use was directly linked to human infections caused by antibiotic resistant bacteria. A journalist even asked if eating meat was safe. Although most of us (including me) support reduction of unnecessary antibiotic use, it’s worth reading this excellent meta-analysis, initiated by WHO. Did this study answer the burning research question “to what extent does animal antibiotic use influence infections in humans?“ Continue reading

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Making MRSA carriage a crime?

A new chapter has been added to our successful MRSA Search and Destroy policy. Yesterday, a healthcare professional, providing homecare to elderly, testified on Dutch television (item starts @ 12.30 minutes) how unnoticed MRSA carriage had influenced her and her family’s life. It is very laudable that she was willing to share her experience, but it was kind of spooky that she felt that she could only do this if unrecognizable, as if the underworld was still after her and her family. Apparently, MRSA carriage has become a criminal or shameful thing. Continue reading

The antibiotic resistance crisis resolved by bacteriophages (part 2)

Earlier this week I blogged on the potential (yet poorly proven) effects of bacteriophages as salvage therapy for infections caused by AMR, and stated: “Phages and their active enzymes are proteins that evoke an immunological host response when injected, and up till now all attempts to circumvene those unwanted effects have failed.” Two recent case reports challenge part of that statement. Continue reading

The antibiotic resistance crisis resolved by bacteriophages

I am regularly asked why we don’t treat infections caused by multidrug resistant bacteria with bacteriophages. Last Friday, the same question made it to the best viewed talkshow on Dutch television (The World Turns On), and in about 10 minutes the global threat of antibiotic resistance was resolved. Here is how….  Continue reading

How to predict ESBL (part 4)

Two months ago I provided an update on the ESBL-predict study that Tim Deelen from our group coordinates. In short: Every hospital in the world can participate, through a user-friendly electronic CRF (in a secured environment), in the validation of 2 scoring systems to predict that sepsis is caused by ESBL-producing bacteria. Only relevant for those of us that are not yet ready to start meropenem/amikacine for every patient that starts with antibiotics! This tool may help, …. if reliable. We passed the 3,000 episodes! Here is a short update and info for those that want to join. Continue reading

The hidden reservoir of SDD users

A next little piece of evidence on the effectiveness of Selective Digestive Decontamination (SDD). Nienke Plantinga pooled all data from the 16,528 patients that had been enrolled in a randomized evaluation of SDD since 25 years, in an Individual Patient Data meta-analysis, see. Not surprisingly SDD was associated with better survival in intensive care unit (ICU), as it was in most of the individual studies. Yet, the pooled etsimates also provide more certainty (and precision) on the beneficical effects of SDD on hospital survival and failed to confirm previous suggestions that SDD was more effective in surgical than in medical patients. Continue reading

Houston, we have a problem

While the world was watching the Texas water ballet with Melanie Trump on stiletto heels, about 1500 people died in South-East Asia because of floodings. And while the western world is searching for another irrelevant mcr-gene, Patrick Musicha soberly describes the true antibiotic resistance crisis in Malawi, see. It is becoming more and more obvious that antibiotic resistance will be the next plague for the least privileged on earth. Continue reading