geoffrey modest medical blogs

  A current  JAMA letter to the editor  ( cdiff recurrent microbiome transplant jama2022  in dropbox, or doi:10.1001/jama.2022.16476)   is a follow-up to the previous article in NEJM nine months earlier by the same research group (for the full earlier article, see   cdiff SER-109 microbiome treatment for recurrent CDI nejm2022   in dropbox, or DOI: 10.1056/NEJMoa2106516, the ECOSPOR III trial). The former article reported C. diff recurrences up until 8 weeks after microbiome transplant, finding a 68% risk reduction independent of patient age or antibiotics received, and that most of the adverse effects were mild to moderate gastrointestinal ones, similar to that found with placebo   Details : -- 182 patients who had at least three C difficile infection (CDI) episodes within 12 months  were enrolled in the trial and randomized  to four capsules daily of SER-109 for three days -- all patients had a positive C. difficile test for toxin...

since i am doing a few blogs on antibiotic overuse and concerns about increasing drug-resistant bacteria, i thought i would add another one on antibiotic-resistant E. coli causing urinary tract infections, per the NY Times on 7/14/19 (see  https://www.nytimes.com/2019/07/13/health/urinary-infections-drug-resistant.html?smid=nytcore-ios-share  ) Details/Comments: --UTIs are among the most common infections in the world --the number of hospitalizations from UTIs has increased 52% from 1998-2011, especially for women and older patients (see  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5414046/  ) --there has been increasing E coli resistance to trimethoprim/sulfamethoxazole (TMP/SMX), with the NY City Dept of Health reporting 1/3 are resistant (as we have certainly seen in Boston over the past few decades) and 1/5 are resist an t to 5 other common treatments     --a Lancet editorial on the 2018 NICE (National Institute for Health and Care Excell...