What to do about MDR-GNR? A rapid reflection from ECCMID 2018

There have been a few important updates on the prevention and control of MDR-GNR from ECCMID, here in Madrid. I thought I’d share a couple of key reflections.

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The antibiotic resistance crisis resolved by bateriophages (part 4)

Yesterday at ECCMID was the long-awaited presentation of the Phagoburn trial: A randomized controlled trial of bacteriophages against Pseudomonas aeruginosa infections in burn wound patients. Bacteriophages have regained considerable attention recently. Proposed as an answer to the rising problems in treating bacterial infections by some, others have remained sceptic due to the absence of evidence of effectiveness coming from well-designed studies, see parts 1, 2 & 3. The Phagoburn trial, though, would the first to deliver high-quality data. So what was presented? Continue reading

The end of investigator-initiated research?

The beauty of ECCMID is the abundance of investigator-initiated studies being presented. The cruelty is that the logistical nightmares that each presenter has gone through to get that study approved and done, cannot be reflected in a 10-minute oral or on a poster. The good news, though, is that that will change: the EU directive 536/2014 will make everything much easier and faster, in order “to let more European patients benefit from recent scientific achievements”. True? …. or does it reduce investigator-suffering by just killing any investigator-initiated study initiative? Continue reading

Teaching how to use antibiotics

Antibiotics are probably the best invention since the discovery of sliced bread. They are very effective, very safe, very cheap and every physician is allowed to prescribe them. Trained as internist, ID specialist and later clinical microbiologist, I would never consider myself qualified for performing an appendectomy. Yet, there is not a single surgeon I know (and that may be biased) that considers him/herself not qualified to prescribe a carbapenem. When asked about the mechanism of action, side effects, costs and ecological risks, the brave face usually turns into the typical “so what” mode. Continue reading

What’s driving increases in MSSA BSI and E. coli BSI in England?

I was recently browsing through the HCAI mandatory reporting data in England (as you do) and noticed that the increasing trend in E. coli BSIs and MSSA BSIs seems to be following a similar trajectory. Could the drivers of these two distinctly different organisms be similar?

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Survey: how do you feel about the future of AMR?

I am doing a talk in Portugal later this week covering the nine decades of antibiotics since Fleming’s discovery in 1928. The last part will be about how the next decade of AMR looks globally – I’d like to know how you’re feeling about this so thought I’d run a quick poll.