• Does Ventilator-Associated Pneumonia really exist?

    Does Ventilator-Associated Pneumonia really exist?

    That’s a question I’ve asked myself many times. If it doesn’t, antibiotics would not be needed, attributable mortality would be absent, and VAP prevention would not increase survival. A new – and excellent – study in Lancet Respiratory Medicine provides new evidence that fits my pre-opinionated and unproven belief. In…

  • Macrolides for community-acquired pneumonia: to add or not to add?

    Macrolides for community-acquired pneumonia: to add or not to add?

    Should patients hospitalized with community-acquired pneumonia (CAP) be treated with macrolides added to a beta-lactam antibiotic? This is a long-lasting discussion.

  • Comparing COVID-19 and influenza

    Comparing COVID-19 and influenza

    Last week, this paper in Lancet ID generated heated (and mostly negative) discussions on X, but I suspect that selection bias may have had a role in that. What was (and was not) investigated? And how?  

  • Nebulized amikacin: preventing positive cultures or VAP?

    Nebulized amikacin: preventing positive cultures or VAP?

    An impressive French study evaluating the effects of nebulized amikacin on the occurrence of ventilator-associated pneumonia (VAP) brought back old memories and a reminder that science moves slowly.

  • Are you safe in a hospital?

    Are you safe in a hospital?

    What do you see when you think back to hospital wards during the heath of the COVID-19 pandemic? Overcrowded, understaffed, chaos. What would the risk be for hospitalised patients not yet infected with SARS-CoV2 in those days?

  • Is the clinical trials enterprise broken?

    Is the clinical trials enterprise broken?

    Last week, I had the privilege to attend JAMA’s first ever summit in which two questions were addressed: ‘Is the clinical trials enterprise broken?’ and ‘How can it be fixed?’. The first question is rhetorical.

  • Antibiotics do more than causing resistance

    Antibiotics do more than causing resistance

    A couple of days ago in a study on continuous antibiotic prophylaxis in children with severe vesicoureteral reflux was published in the NEJM. An international open-label RCT with 292 kids enrolled over a period of (!) 7 years.

  • Female surgeons do better!/?

    Female surgeons do better!/?

    On my way to my 85-year-old dad who suffered from paralytic ileus after laparotomic hemicolectomy, I heard the following news: “Patients from female surgeons have less long-term postoperative complications (including death)“ (see: Wallis et al., JAMA Surg.). Is that what the study really revealed?

.

acute kidney injury adaptive designs antibiotic resistance antimicrobial resistance bad science children clinical trials community-acquired pneumonia COVID-19 data diagnostics ESCMID Global Guy Thwaites hospital infection influenza methods pandemic pneumonia s. aureus self-controlled case series SNAP surgery urinary tract infection vaccine ventilator-associated pneumonia