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

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HAP: In the ‘too difficult box’?

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User:KGH at Wikimedia Commons

I’ve had an enjoyable time at ICPIC. Sessions (abstracts here) have been great, speakers excellent, meeting well-organised but one session rattled my cage. Point prevalence surveys (PPS) and their value was an interesting session, however at the end of it I was wondering whether this was ‘Surveillance in action’ or ‘Surveillance inaction’. Continue reading

The Big C

Screen Shot 2017-06-12 at 13.42.20I’ve blogged before about compliance. It’s a big thing for me. If I had a pound (actually after the last week, if I had a dollar) for every time that I think I’ve implemented some intervention to find after a while that it has not been embedded I’d be on a yacht in the Med. But I’m not, instead I’m reading the very nice meta-analysis of the effectiveness of bundles in preventing CLABSI recently published in the Lancet ID. Ok, so the conclusion is that bundles work, but it’s not that which interested me, as a glance at the figures made me consider whether we should move on from effectiveness to implementation. Continue reading

Friday Afternoon: ATP vs UV vs eyeball Vs K9 and Going Commando in Surgery

Screen Shot 2017-06-02 at 12.26.42Well I was looking for a Friday afternoon sort of post and you know when you wait a while and two come at once?.. So firstly, some may recall that I have previously highlighted the utility of a sensitive nose in detecting a variety of things in a previous post. In a study just posted online first in the Journal of Hospital Infection, a springer spaniel was trained to detect C. difficile in the environment with a fair degree of success, especially for detecting rooms in which C. difficile was not present. Continue reading

How to predict ESBL BSI (part 2)

A month ago (April 11) I blogged on the difficulties in predicting the presence of ESBL-producing bacteria as a cause of infection at the time antibiotics must be started. Wouter Rottier (PhD student) developed 2 prediction rules (for community-onset and hospital-onset infection), that seem to do better than current guideline recommendations (especially for reducing unnecessary carbapenem use). Another PhD student (Tim Deelen) now wants to validate these rules, globally. The “crowd-funding study approach” worked and sites across the world joined us…. Continue reading