CPE guidelines galore: ECDC and ACSQH join the party

I recently posted on the WHO CPE guidelines. A couple of people have alerted me to two other recently published guidelines, one from ECDC, and the other from Australian Commission  on Safety and Quality in Healthcare. So, we now have a wealth of guidelines to prevent and control CPE. But how to they compare?

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The antibiotic course has had its day?

Schermafbeelding 2017-07-27 om 10.19.00

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.”

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The anatomy of a good blog

ICHE recently published an unusual article (which other article has ‘the world wide web’ as their setting) on blogging in ID and clinical micro. The article reviewed around 100 blogs and rated them using a multifaceted tool. The article has some useful qualitative feedback from bloggers and readers, and identifies some gaps in the blogosphere (especially around antimicrobial stewardship). Rachael Troughton, one of the study authors, recently published a post on the article – and here’s my take on it.

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The English C. difficile miracle: is it all about fluoroquinolones?

A new Lancet ID study suggests that restriction of fluoroquinolone usage has been the main driver of the national reduction in C. difficile infection in England. This paper is challenging in terms of some of the accepted approaches to controlling the transmission of C. difficile: if it’s all about reducing fluoroquinolones (and antimicrobials in general) and nothing to do with these measures, then why invest so much time and energy in isolation of symptomatic cases, cleaning and disinfection etc?

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ESPAUR 2016: an early Christmas present

espaur-2016

I am just getting around to reading (well detail-scanning the exec summary) of the ESPAUR report. My main reflection is what a fantastic resource this reporting stream offers us: to have freely accessible, regular, accurate, national data on antimicrobial resistance and usage, and other related indicators is pretty unique!

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What do nurses have to do with anti-infective stewardship?

nurse

Nurses are usually non-prescribers, so that means that anti-infective stewardship is the domain of the prescribing doctors and pharmacists, right? Wrong! Nurses have an enormous and enormously under-estimated role in anti-infective stewardship! Continue reading

Online antimicrobial stewardship course

I found out about a new free online antimicrobial stewardship course yesterday. The course is a collaboration between the the University of Dundee and the British Society for Antimicrobial Chemotherapy, and comes highly recommended. The course is designed for healthcare professionals.

If anybody completes the course, I’d be interested to hear your feedback.