To me, the end of 2019 was mind troubling. My deeply beloved mother, 76 years, was hospitalized on Dec 4th and passed away on Dec 19th due to end stage COPD. At the same time I was reading Samuel Shem’s new novel, Man’s 4th Best Hospital, the sequel to The House of God. The contrast created by my mothers’ treatment in one the smallest hospitals in our country and the book content could not have been greater, neither was the prospect of modern medicine more grim. Continue reading
health
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
Synbiotics and neonatal sepsis
With this blog I am leaving my beaten path: neonatal sepsis and probiotics. But so does this double-blind placebo-controlled study published today in Nature. To me, probiotics are still “something promising since 25 years”, without ever having substantiated that promise (like Ajax and the Chicago Cubs, until recently). In fact, colleagues of mine once led a study in which probiotics apparently killed patients with acute pancreatitis. This new study may change my view completely.
The antibiotic course has had its day?
In a recent BMJ article, Llewelyn et al. argue that the old dogma of completing a prescribed course of antibiotics to prevent antibiotic-resistance is a myth, not based on evidence. Actually the opposite, namely taking antibiotics for longer than necessary, increases the risk of resistance.
While I love breaking down old dogmas (we actually had a poll on this topic some time back), many of today’s papers in the Netherlands (and I am pretty sure elsewhere, too) misinterpret the study, by slaughtering the message to patients to “always complete the full prescription”. One of the Netherlands most influential newspapers the Volkskrant, already wrote: “Finishing antibiotic course? Nonsense.”
Reflections on Infection Prevention and Control 