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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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

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

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

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.

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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