Author Interviews, Infections, JAMA / 08.09.2020

MedicalResearch.com Interview with: Yaa-Hui Dong PhD Faculty of Pharmacy National Yang-Ming University Taipei, Taiwan MedicalResearch.com: What is the background for this study? Response: Previous observational studies found that fluoroquinolones may be associated with more than 2-fold increased risk of aortic aneurysm or aortic dissection (AA/AD). However, these studies might not well address the influence of concurrent infection, which is also a suggested risk factor for AA. Moreover, most of these studies compared fluoroquinolone use versus no fluoroquinolone use, which might overestimate the risk with fluoroquinolones as patients on fluoroquinolones may have more severe infection versus those not on fluoroquinolones. (more…)
Author Interviews, Clots - Coagulation, NEJM / 12.08.2020

MedicalResearch.com Interview with: Elizabeth Webb, M.P.H Physiotherapy Department Calvary Public Hospital Bruce Bruce, Australia MedicalResearch.com: What is the background for this study? Response: Our study showed that in patients with a history of leg swelling (chronic edema), compression therapy by a skilled lymphedema therapist reduced the risk of infection in the leg (cellulitis) by a huge 77%. With up to 47% of patients experiencing recurrence of cellulitis in their legs within 3 years, this result is a game-changer in terms of our approach to managing patients with leg swelling and recurrent cellulitis. Until now, the use of prophylactic antibiotics to prevent cellulitis has been the only evidence-based practice. We know however, there are many reasons why avoidance of antibiotics is important within our community. (more…)
Author Interviews, JAMA, Pediatrics, Weight Research / 29.01.2020

MedicalResearch.com Interview with: Dr. Carol Chelimo PhD Research Fellow Dept. of Paediatrics, School of Medicine University of Auckland MedicalResearch.com: What is the background for this study? Response: New Zealand has the third highest prevalence of obesity among Organisation for Economic Co-operation and Development countries. Pediatric obesity is associated with development of cardiovascular risk factors in later life, such as type 2 diabetes, hypertension, dyslipidemia, and metabolic syndrome. Antibiotic exposures in early life may affect weight by altering the gut microbiota, potentially increasing the risk of childhood obesity. The overall aim of this research was to examine whether repeated antibiotic exposure by age 48 months is associated with higher body mass index (BMI) at age 54 months. Specifically, it evaluates whether the number, timing (age), and type of antibiotic exposures are associated with a higher body mass and an increased likelihood of overweight and obesity. This work incorporates antibiotic exposure during pregnancy (more…)
Allergies, Author Interviews, C. difficile, Dental Research, Infections / 05.10.2019

MedicalResearch.com Interview with: Alan E. Gross, PharmD Clinical Assistant Professor University of Illinois Chicago, IL MedicalResearch.com: What is the background for this study? Response: Dentists prescribe 10% of all outpatient antibiotics. Most of this prescribing is for infection prophylaxis prior to dental procedures. Our prior research has found that 80% of prescriptions for dental prophylaxis is unnecessary. Although antibiotic prophylaxis prior to dental procedures is often for a short course (e.g. one time amoxicillin dose), there may be patient harm associated with this. (more…)
Author Interviews, Biomarkers, NEJM, Pulmonary Disease / 11.07.2019

MedicalResearch.com Interview with: Dr. Chris Butler,, BA MBChB DCH CCH MD FRCGP (Hon)FFPH FMedSci Professor of Primary Care Nuffield Department of Primary Care Health Sciences, Professorial Fellow at Trinity College Clinical Director Primary Care Clinical Trials Unit University of Oxford  MedicalResearch.com: What is the background for this study? Response: More than a million people in the UK have COPD, which is a lung condition associated with smoking and other environmental pollutants. People living with the condition often experience exacerbations, or flare-ups, and when this happens, three out of four are prescribed antibiotics. However, two-thirds of these flare-ups are not caused by bacterial infections and antibiotics often do not benefit patients. A simple finger-prick blood test could help prevent unnecessary prescribing of antibiotics for people with the lung condition chronic obstructive pulmonary disease (COPD).  The finger-prick test measures the amount of C- reactive protein (CRP) - a marker of inflammation that rises rapidly in the blood in response to serious infections. People with a COPD flare-up who have a low CRP level in the blood appear to receive little benefit from antibiotic treatment. The General Practitioner (GP) use of a C-Reactive Protein (CRP) Point of Care Test (POCT) to help target antibiotic prescribing to patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) who are most likely to benefit (The PACE Study) determined whether the using a POCT CRP to guide antibiotic treatment decisions for acute exacerbations of COPD reduced antibiotic use without harming patients. (more…)
Annals Internal Medicine, Author Interviews, Infections, University of Michigan / 09.07.2019

MedicalResearch.com Interview with: Valerie M. Vaughn, MD MSc Assistant Professor of Medicine and Research Scientist, Division of Hospital Medicine The Patient Safety Enhancement Program and Center for Clinical Management Research Michigan Medicine and the Ann Arbor VA Medical Center  MedicalResearch.com: What is the background for this study? Response: Pneumonia is one of the top causes for hospitalization and one of the main reasons for antibiotic use in US hospitals. In the past decade, studies have suggested that patients can be safely treated with short course antibiotic therapy instead of the prolonged courses we used to prescribe. Our study looked at prescribing practices in 43 hospitals across the state of Michigan to see if we were appropriately prescribing short course therapy, and if so, how that affected patients. (more…)
Author Interviews, Infections / 24.06.2019

MedicalResearch.com Interview with: David Houston PhD Senior Scientist and wound project Neem Biotech MedicalResearch.com: What is the background for this study?   Response: Biofilms are complex bacterial communities formed during the natural infection process as a protection mechanism and controlled by bacterial quorum sensing. These biofilm communities allow infections to spread by producing toxins that inhibit the body’s immune system, generating exopolysaccharide and changes in metabolic state that reduce the efficacy of antibiotics and activating virulence factors, which ultimately drive the spread of infection. Stopping the spread of infection by inhibition of quorum sensing has potential to manage a wide range of infections, including in wounds. In chronically-infected wounds, the prevention of biofilm formation, disruption of mature biofilms, reduction of virulence factors and thereby the spread of infection remains clinically elusive. Quorum sensing (QS) pathways regulate microbial motility, virulence factor production and the formation and maturation of biofilms. Inhibiting QS therefore presents a potential mode of therapeutic intervention for infections. (more…)
Author Interviews, Dermatology, Infections, JAMA / 19.06.2019

MedicalResearch.com Interview with: Richard Brindle DM FRCP Honorary Reader, University of Bristol, UK  MedicalResearch.com: What is the background for this study? Response: This review is an update of the 2010 Cochrane Review of Interventions for cellulitis and erysipelas (DOI: 10.1002/14651858.CD004299) but focusing on antibiotics.  It provides a valuable resource for clinicians in summarizing current best evidence and highlighting gaps in the research. This review will inform the production of evidence-based guidelines covering antibiotic choice, route of administration, duration of treatment and the role of combinations of antibiotics. (more…)
Author Interviews, Dental Research / 02.06.2019

MedicalResearch.com Interview with: Dr. Katie Suda, PharmD, M.S.  Associate Professor College of Pharmacy University of Illinois at Chicago  MedicalResearch.com: What is the background for this study? Response: Dentists prescribe approximately 1 in every 10 antibiotics in the United States and are the top specialty prescriber. Dentists are the primary prescriber of clindamycin in the U.S., which is associated with a high risk of C. difficile infection (an overgrowth of bacteria in the GI tract that can cause a life-threatening infection). Clinical guidelines recommend that patients with specific cardiac conditions receive a dose of antibiotics prior to undergoing invasive dental procedures to prevent infective endocarditis (an infection of the heart values). Taking a dose of antibiotics prior to a dental visit is referred to as antibiotic prophylaxis. Starting in 2007, these guidelines were narrowed secondary to poor evidence on the effectiveness of antibiotic prophylaxis and the risk of antibiotic-related adverse events. Antibiotic adverse events include antibiotic resistance, C. difficile infection, and other general adverse events (nausea, vomiting, diarrhea). While significant research has been conducted on unnecessary prescribing of antibiotics by medical providers, little work has described appropriateness of prescribing by dentists. We assessed if antibiotics prescribed for prophylaxis prior to dental procedures were consistent with clinical guidelines. (more…)
Author Interviews, Heart Disease, Women's Heart Health / 29.04.2019

MedicalResearch.com Interview with: Dr. Lu Qi MD PhD Department of Epidemiology, School of Public Health and Tropical Medicine Tulane University New Orleans, LA 70112 Department of Nutrition, Harvard T.H. Chan School of Public Health, Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School Boston, MA 02115 Yoriko Heianza RD, PhD Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University New Orleans, LA  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Growing data suggest that antibiotic exposure is associated with a long-lasting alteration in gut microbiota, and may be related to subsequent cardiovascular disease (CVD). We investigated associations of duration of antibiotic use in different phases of adulthood (young, middle and late adulthood) with the CVD incidence among women at usual risk. This new analysis from the Nurses’ Health Study shows that women who take antibiotics for long periods, especially during more recent adulthood (such as  in middle- and late adulthood) had a higher risk of CVD in later life.  (more…)
Author Interviews / 18.03.2019

MedicalResearch.com Interview with: Darwin Chen, MD Assistant Professor of Orthopedic Surgery Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings? Response: Periprosthetic joint infection unfortunately remains a leading cause of total knee arthroplasty failure. One method of mitigating the risk of PJI is to use antibiotic loaded bone cement in a prophylactic fashion. While the use of antibiotic cement makes inherent sense, the decision is not as simple as it seems. There are potential side effects such as renal damage, antibiotic hypersensitivity, and antibiotic resistance. Antibiotics decrease the mechanical strength of cement fixation, which may impact component loosening. Additionally, antibiotic cement is significantly more expensive than standard cement, driving up cost. Currently there is no consensus on if antibiotic cement truly reduces infection risk and there are many conflicting studies. The purpose of our study is the use a large national database to evaluate real world utilization patterns of antibiotic cement, and assess outcomes, complications, and cost associated with antibiotic cement usage. Our hypothesis was that antibiotic cement is associated with a decreased risk of infection and no increased risk of systemic complications.  (more…)
Author Interviews, Dermatology, JAMA, Johns Hopkins, Microbiome / 15.02.2019

MedicalResearch.com Interview with: Luis Garza, MD-PhD Associate Professor Department of Dermatology Johns Hopkins School of Medicine Baltimore, MD 21287 MedicalResearch.com: What is the background for this study? What are the main findings?  Do you think these findings would be similar with other antibiotics (oral or topical) or with isotretinoin for acne? Response: We prescribe antibiotics frequently for acne. We certainly know it affects our normal and abnormal bacteria on our skin. But we don’t fully understand how well or not people recover from antibiotics.  (more…)
Antibiotic Resistance, Asthma, Author Interviews, JAMA / 04.02.2019

MedicalResearch.com Interview with: Mihaela S Stefan, MD, PhD FACP Research Scientist, Institute for Healthcare Delivery and Population Science Associate Professor, UMMS-Baystate Director of Perioperative Clinic and Medical Consultation Program Academic Hospitalist Director Quality Assessment, Division of Healthcare Quality Springfield MA MedicalResearch.com: What is the background for this study? What are the main findings? Response: In a prior study we have found that roughly 41% of patients hospitalized with an asthma exacerbation receive antibiotics although the guidelines do not support this practice. We found that the evidence supporting the guidelines was however limited to 6 trials which included a total of only 681 adults and children and most trials’ outcomes were symptoms or lung function not length of stay, need for mechanical ventilation, readmissions or death. We performed the largest observational study to-date of approximately 20 000 patients hospitalized for asthma exacerbation and found that patients treated with antibiotics did not have better outcomes but instead they had longer hospital stay and an increased risk for antibiotic-related diarrhea. (more…)
Author Interviews, Gastrointestinal Disease, Microbiome, Nature / 11.01.2019

MedicalResearch.com Interview with: Dr. Venkatakrishna R Jala, PhD Assistant Professor James Graham Brown Cancer Center Department of Microbiology and Immunology University of Louisville MedicalResearch.com: What is the background for this study? What are the main findings? Response: Humans evolved along with their gut microbiota and adapted their physiological activities to help each other. Along with consumption of healthy diets, humans must harbor the appropriate microbiota to convert the foods into available components called metabolites. These microbial metabolites play a critical role in preserving homeostasis, the development of immune systems and preventing adverse events both systemically and locally. Despite the availability of large metagenomics (bacterial sequence) data, and its associations with disease conditions, the functional dynamics of microbiota (good vs bad) in human health or diseases are yet to be defined. The host’s indigenous gut microbiota and its metabolites have emerged as key factors that greatly influence human health and disease, including inflammatory bowel diseases (IBD). IBD patients suffer from leaky gut and increased inflammation. The current study demonstrates that a microbial metabolite derived from ellagitannin/ellagic acid rich diets (e.g., pomegranate, berries) called ‘urolithin A’ and its synthetic analogue significantly enhance gut barrier function in addition to blocking the unwarranted inflammation in IBD animal models.  (more…)
Author Interviews, Infections, Pediatrics, Pulmonary Disease / 08.11.2018

MedicalResearch.com Interview with: Andrea Hahn, M.D., MS Infectious disease specialist and lead study author Children's National Health System MedicalResearch.com: What is the background for this study? What are the main findings? Response: People who have the genetic disease cystic fibrosis have increased sticky secretions in their lungs that put them at risk for repeated bacterial infections. They often will receive courses of intravenous antibiotics to treat more severe or difficult-to-treat infections associated with decreased lung function. However, not all patients fully recover their lung function after antibiotic treatment, despite directing antibiotic therapy toward the specific bacteria thought to be causing the infection. The goal of this study was to determine if the pharmacokinetics of commonly used antibiotics was associated with recovery of lung function. First, we found that patients with therapeutic blood levels of beta-lactam antibiotics had better lung recovery than patients with sub-therapeutic levels of these antibiotics. Second, we found that using higher antibiotic dosing according to Cystic Fibrosis Foundation guidelines was not sufficient to predict which patients would have therapeutically meaningful blood levels of antibiotics. (more…)
Author Interviews, NEJM, STD / 07.11.2018

MedicalResearch.com Interview with: Edward W. Hook, III, MD University of Alabama at Birmingham Medicine / Infectious Diseases Birmingham, AL MedicalResearch.com: What is the background for this study? What are the main findings? Response: Zoliflodacin represents a new class of antibiotics (spiropyrimidinetriones) with in vitro activity against Neisseria gonorrhoeae, as well as other STD  pathogens (Chlamydia trachomatis and Mycoplasma genitalium).  Because of this promising data and the fact that the manufacturer (Entasis Pharmaceuticals) was willing to pursue the possibility of using this drug to treat gonorrhea, a Phase II trial was conducted which showed he drug to be 96% effective for genital or rectal infections.  The drug was well tolerated as well making it a promising drug for gonorrhea treatment which might help to combat the increasing problem of antibiotic resistant gonorrhea.  (more…)
Author Interviews, Global Health, Hospital Acquired, Infections, Lancet / 07.11.2018

MedicalResearch.com Interview with: "Antibiotics" by Michael Mortensen is licensed under CC BY-SA 2.0Dr Alessandro Cassini MD Epidemiologist, European Centre for Disease Prevention and Control Solna, Sweden MedicalResearch.com: What is the background for this study? Response: We published an ECDC study estimating attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the European Union and the European Economic Area (EU/EEA). This study is based on 2015 data from the European Antimicrobial Resistance Surveillance Network (EARS-Net). The study was developed by experts at ECDC and the Burden of AMR Collaborative Group, and published in The Lancet Infectious Diseases. (more…)
Author Interviews, BMJ, Pediatrics, Weight Research / 01.11.2018

MedicalResearch.com Interview with: "babies (365-222)" by Robert Couse-Baker is licensed under CC BY 2.0Dr. Christopher M Stark Department of Pediatrics William Beaumont Army Medical Center El Paso, Texas Department of Pediatrics Walter Reed National Military Medical Center Bethesda, Maryland MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Rates of pediatric obesity have increased over the past decade, which has led researchers to search for modifiable risk factors that may explain this increase. Recent studies have identified an association between native gut bacteria alterations and the development of obesity. Several population-based studies have evaluated whether or not there is an association between antibiotic exposure and the development of obesity, with mixed results. No studies have previously evaluated if acid suppressing medications are associated with developing obesity. We found that young children prescribed antibiotics, acid suppressants, and combinations of these medications in the first two years of life are more likely to develop obesity after two years of age. Our study represents the largest study to evaluate pediatric antibiotic prescriptions and obesity risk, with nearly ten times as many patients as the next largest study. (more…)
Author Interviews, Infections, Lancet, Urinary Tract Infections / 27.10.2018

MedicalResearch.com Interview with: https://www.shionogi.com/Simon Portsmouth, MD Senior Medical Director Shionogi Inc. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Antibiotics for multidrug resistant  Gram-negative infections are desperately needed. Cefiderocol is the first siderophore antibiotic to reach patients. Siderophore antibiotics bind to free iron and use the bacterial active iron transport channels to cross the outer membrane of Gram-negative bacteria. Laboratory studies have shown that cefiderocol is active against multi-drug resistant Gram-negative bacteria, often where no other antibiotics are active. It is able to overcome most types of antibiotic resistance due to its active transport into cells and stability against all carbapenemases. The need for antibiotics for carbapenem resistant Gram-negative infections is described as a critical need by the WHO. This trial was the first in humans with serious infections and demonstrated excellent efficacy in a complicated patient population where almost ¼ were over 75 years of age. Additionally cefiderocol did not appear to have any safety problems, and was well tolerated. (more…)
Author Interviews, Baylor College of Medicine Houston, JAMA, Surgical Research / 12.10.2018

MedicalResearch.com Interview with: Scott A. LeMaire, MD Jimmy and Roberta Howell Professor of Cardiovascular Surgery Vice Chair for Research, Michael E. DeBakey Department of Surgery Professor of Molecular Physiology and Biophysics Director of Research, Division of Cardiothoracic Surgery Baylor College of Medicine Department of Cardiovascular Surgery Texas Heart Institute Baylor St. Luke’s Medical Center CHI St. Luke’s Health Editor-in-Chief, Journal of Surgical Research MedicalResearch.com: What is the background for this study? What are the main findings? Response: We performed this study because of concerns about the potential association between fluoroquinolones and aortic aneurysms and dissection raised in two large clinical studies. This concern was noted by the US Food and Drug Administration in May 2016, but the evidence was not deemed sufficient to warrant a warning. Hence, there was a clear need for additional studies to evaluate the problem. Our study was designed to determine whether there is biological evidence that ciprofloxacin—the most commonly prescribed fluoroquinolone—exacerbates aortic disease in a well-established mouse model. The model uses high-fat diet and angiotensin II infusion to stress the aorta and cause aneurysm and dissection. Using this model, we compared mice that received ciprofloxacin to control mice that received only vehicle, and we found that mice that received ciprofloxacin had significant increases in the incidence of aortic dilatation, severe aortic aneurysm and dissection, and aortic rupture and premature death. Importantly, these findings were consistent in male and female mice. Further, we investigated the potential underlying mechanisms and found that the aortas from mice that received ciprofloxacin had decreased levels of lysyl oxidase, increased levels of matrix metalloproteinases, and increased levels of apoptosis and necroptosis. (more…)
Author Interviews, Dermatology, Pharmaceutical Companies / 09.10.2018

MedicalResearch.com Interview with: foamixDavid Domzalski CEO Foamix Pharmaceuticals MedicalResearch.com: What is the background for this study?  How does FMX101 differ from other treatment for acne, ie benzoyl peroxide, topical clindamycin etc?  Response: This study measures the safety and efficacy of a topical foam formulation of the antibiotic minocycline, for the treatment of moderate-to-severe acne. Minocycline is one of the most commonly used products for the treatment of acne, but is currently only available in an oral dosage form. Significant side effects are associated with oral minocycline, including GI upset, photosensitivity, headaches, dizziness, and other potential effects on the CNS.  In addition to the side effects associated with oral minocycline, many currently available topical acne medications contain ingredients which can be drying and irritating to the skin.  These side effects can be frustrating to patients and potentially impact overall compliance to their treatment regimen.  The study addresses important unmet needs in dermatology to determine whether providing patients with a topical dosage form of minocycline may have potential advantages over existing products. In our first two Phase 3 clinical studies, >95% of facial local tolerability signs and symptoms were classified as “none” or “mild,” including dryness, erythema and itching.  Also, our topical minocycline foam, FMX101, is a natural triglyceride-based vehicle that does not contain ingredients that serve as  primary irritants or surfactants.  We believe that FMX101, if approved, would be the first topical minocycline available for the treatment of acne and provide a novel and much needed treatment option for patients who suffer from the physical and psycho-social effects of acne. (more…)
Antibiotic Resistance, Author Interviews, Infections / 08.10.2018

MedicalResearch.com Interview with: David G. Thanassi, Ph.D. Professor and Interim Chair Department of Molecular Genetics & Microbiology Center for Infectious Diseases Stony Brook University Stony Brook, NY 11794-5222 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pathogenic bacteria such as Escherichia coli use hair-like surface appendages termed pili to colonize tissues within the host and initiate infection.  Together with our collaborators - the group of Huilin Li at the Van Andel Research Institute - we used an advanced imaging technique termed cryo-electron microscopy to determine snapshots of bacterial pili as they are being assembled.  The pili we studied are critical for uropathogenic strains of E. coli to colonize the urinary tract and cause urinary tract infections.  Our work revealed a new stage in the pilus assembly process and new details about how these structures are built on the bacterial surface.   (more…)
Author Interviews, C. difficile, Critical Care - Intensive Care - ICUs, Infections / 07.10.2018

MedicalResearch.com Interview with: Richard Hengel, MD, FRCPC, FACP Atlanta ID Group Richard Hengel, MD, FRCPC, FACP Atlanta ID Group MedicalResearch.com: What is the background for this study? How does Bezlotoxumab differ from other medications for recurrent C. difficile infections? Response: Clostridium difficile infection (CDI) is now the most common hospital acquired infection in the United States, accounting for significant morbidity and mortality, not only in the US, but around the world. Despite standard antibiotic therapy targeting the Clostridium difficile bacterium directly, recurrent infection is common, occurring in a quarter to a third of patients, often frail individuals with other concurrent medical problems. These patients can have multiple recurrences leading to their progressive deterioration over time. Until recently, the only treatment for CDI included antibiotics. More recently, fecal microbiota transplant is a promising, but as yet, FDA unapproved therapy. Bezlotoximab is a new FDA approved treatment for recurrent Clostridium difficile infection (rCDI) that compliments standard antibiotics. Bezlotoxumab is a monoclonal antibody targeting toxin B produced by Clostridium difficile during CDI. In two large treatment trials, bezotoxumab, in addition to standard-of-care antibiotics, reduced the frequency of CDI recurrences from about 28% to about 18%. In this study, we set out to see if this new drug performed as well in actual clinical practice as it did in the published clinical trials. (more…)
Author Interviews, Primary Care, Respiratory, Telemedicine / 02.10.2018

MedicalResearch.com Interview with: Dr. Kathryn A. Martinez PhD MPH CanSORT Cancer Surveillance and Outcomes Research Team Cleveland Clinic MedicalResearch.com: What is the background for this study? What are the main findings? Response: Most upper respiratory infections are viral and therefore should not be treated with antibiotics. Despite this, physicians commonly prescribe them for these conditions. Patients often expect antibiotics for respiratory tract infections.  As a result, physicians may find it easier to give patients what they want rather than explain to them why antibiotics aren’t needed. We hypothesized it also might be more time consuming for physicians to explain to patients why they don’t need antibiotics, which creates a further incentive to prescribe them. To explore this potential phenomenon, we used data from a large direct to consumer telemedicine system to assess differences in medical encounter length by prescription outcome for patients diagnosed with respiratory tract infections. We found that encounters resulting in antibiotics were 0.33 minutes shorter than those that resulted in no prescriptions, supporting our hypothesis that prescribing an antibiotic takes less time than prescribing nothing. (more…)
Author Interviews, Microbiome / 26.09.2018

MedicalResearch.com Interview with: Pushpa Pandiyan, PhD Assistant Professor, Biological Sciences School of Dental Medicine Case Western Reserve University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The objective was to find the role of the resident bacteria in the mouth in controlling oral immunity. We examined this in a oral fungal infection model. How resident microbiome in the mouth maintains a healthy oral immune system was unknown before. We found that antibiotics led to destruction of microbiome and some of the good fatty acids the bacteria produced. This created an immune imbalance in the local tissue, thus making the host more susceptible to the fungal infection.  (more…)
Antibiotic Resistance, Author Interviews, Infections / 25.09.2018

MedicalResearch.com Interview with: "pseudomonas first bacteria to be patented. professor Chakrabarty" by adrigu is licensed under CC BY 2.0Dr Dorival Martins Department of Microbiology and Immunology Meakins-Christie Laboratories, Research Institute McGill University Health Centre Montreal Canada.  MedicalResearch.com: What is the background for this study? Response: Antibiotic tolerance, together with drug resistance, makes bacteria refractory to antibiotics and can cause treatment failure in subacute and chronic bacterial infections. Pseudomonas aeruginosa, a major health concern worldwide, can cause severe chronic infections that are refractory to antibiotic treatments due to tolerance. Since the discovery of new antibiotics has been drastically diminished over the last decades, overcoming tolerance could be a strategy to enhance the efficacy of currently available antibiotic treatments. However, very little is known about the mechanism of tolerance, even though this phenomenon has been observed over 60 years ago. (more…)
Allergies, Author Interviews, CDC, Infections, Pediatrics / 25.08.2018

MedicalResearch.com Interview with: Maribeth C. Lovegrove, MPH Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Atlanta, GA 30333). MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been a lot of recent attention on reducing unnecessary antibiotic prescribing in order to reduce antibiotic resistance (a longer-term harm).  However, antibiotic use also can lead to shorter-term harms like allergic reactions and other side effects.  With this analysis, we wanted to focus on the acute harms to individual pediatric patients from antibiotic use in order to help target prevention efforts.  Specifically, we used data from two national data sources to identify the antibiotics with the highest numbers of emergency department visits for adverse drug events and the highest rates of emergency department visits for adverse drug events (accounting for amount of antibiotic prescriptions dispensed) and to identify the pediatric patients with the highest risks. (more…)
Author Interviews, CDC, Infections, JAMA / 20.07.2018

MedicalResearch.com Interview with: Dr. Katherine Fleming-Dutra MD Deputy Director Office of Antibiotic Stewardship CDC MedicalResearch.com: What is the background for this study? Response: Antibiotics are life-saving medications that treat bacterial infections. Any time antibiotics are used, they can lead to antibiotic resistance and could cause side effects such as rashes and adverse events, such as Clostridium difficile infection, which is a very serious and sometimes even fatal diarrheal disease. This is why it is so important to only use antibiotics when they are needed. When antibiotics aren’t needed, they won’t help you and the side effects could still hurt you. A previous study* reported at least 30% of antibiotic prescriptions written in doctor’s offices and emergency departments were unnecessary. However, the data from that study did not include urgent care centers or retail health clinics. We conducted the current analysis to examine antibiotic prescribing patterns in urgent care centers, retail health clinics, emergency departments, and medical offices. *Fleming-Dutra, K., et al. (2016). "Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011." JAMA: the Journal of the American Medical Association 315(17): 1864-1873. https://jamanetwork.com/journals/jama/fullarticle/2518263 (more…)
Author Interviews, Biomarkers, Infections, NEJM, University of Pittsburgh / 19.07.2018

MedicalResearch.com Interview with: David T. Huang, MD, MPH Associate Professor, Critical Care Medicine, Emergency Medicine, Clinical and Translational Science Director, MACRO (Multidisciplinary Acute Care Research Organization) Director, CRISMA Administrative Core (Clinical Research, Investigation, and Systems Modeling of Acute illness) University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: The overuse of antibiotics has become a serious threat to global public health, causing antibiotic resistance and increasing health care costs. Physicians have long known that antibiotics are usually unnecessary for acute bronchitis and for some other cases of lower respiratory tract infections, and that antibiotics treat only bacterial infections, not viral. But in daily practice, many physicians often prescribe them. Previous research had reported that using a biomarker blood test and following an antibiotic guideline tied to the test results could reduce antibiotic use in lower respiratory tract infections. In February 2017, the U.S. Food and Drug Administration approved the biomarker test that measures procalcitonin – a peptide that typically increases in bacterial infections, but not viral. We conducted the Procalcitonin Antibiotic Consensus Trial (ProACT) trial to evaluate whether a procalcitonin antibiotic prescribing guideline, implemented for the treatment of suspected lower respiratory tract infection with reproducible strategies, would result in less exposure to antibiotics than usual care, without a significantly higher rate of adverse events. The ProACT trial involved 14 predominately urban academic hospitals. We enrolled 1,656 adult patients who presented to the hospital emergency department and were initially diagnosed with a lower respiratory tract infection. All the patients were tested for their procalcitonin levels, but the results were shared only with the physicians of the patients randomly assigned to procalcitonin-guided antibiotic prescription. (more…)