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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Being prepared for the next pandemic

One of the first things you learn in medical school (or at least the oldest thing I remember from that time) is that the next flu pandemic can happen any time, now! You can’t argue with it, and it holds for all pathogens with pandemic potential. Pandemics (or what could become one) are threatening (think of Ebola and SARS) and usually give rise to many questions, such as what is the optimal diagnostic approach, treatment and prevention strategy. Research plans emerge, but before the studies can start, the pandemic is over, and hardly anything has been learned. That, now, should end. Continue reading

When quality improvement fails

In this weeks’ PhD journal club Darren Troeman discussed the paper “Effect of a multifaceted educational intervention for anti-infectious measures on sepsis mortality: a cluster randomized trial”.  The plan was to improve compliance with guidelines, thereby reducing time before start of antimicrobial therapy (AT) which should reduce 28-day mortality. The intervention was compared to conventional medical education. Disappointingly, the trial provided more lessons for trialists than for healthcare providers. Continue reading

Publish or perish

Our careers (at least partly) depend on our publications. The more, the better and to suit our needs we have a journal for any kind of publication. Sometimes, you read something and you may think “Hey, I have seen that before”. If the new study than confirms a previous finding, we apparently have a reproducible fact, which increases the likelihood that it is indeed true. Here is an example. Or not? 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

Inferior but not non-inferior: How a Data Safety Board can kill a study

The old dogma to “always complete your antibiotic course” has been challenged recently, see BMJ and previous blogs. Is it safe to tell patients to stop whenever they feel better? Purely by coincidence this paper appeared, and was discussed in our PhD’s Journal Club. The paper’s title was Individualizing duration of antibiotic therapy in community-acquired pneumonia (CAP), and the students were surprised by the final result, reports Valentijn Schweitzer. Continue reading