Thursday, December 20, 2007

Developing antibiotic resistance

Bacterial resistance to antibiotics has come up in several of our case studies - a post this summer from the Wall Street Journal Health Blog discussed a paper from PNAS about this very topic and highlights how quickly some bacterial strains are able to develop mutations that reduce or completely impair the effectiveness of some antibiotics against them - "Evolution in Real Time: How Bacteria Beat Antibiotics":

The microbes that killed an unnamed patient seven years ago accumulated 35 separate genetic mutations during a 12-week hospital stay, allowing the bugs to thwart every antibiotic doctors threw at them, a painstaking scientific investigation has found.
The study itself: Mwangi MM, Wu SW, Zhou Y, Sieradzki K, de Lencastre H, Richardson P, Bruce D, Rubin E, Myers E, Siggia ED, Tomasz A. Tracking the in vivo evolution of multidrug resistance in Staphylococcus aureus by whole-genome sequencing. Proc Natl Acad Sci U S A. 2007 May 29;104(22):9451-6.

Friday, December 07, 2007

Clinical trials

The PLoS Medicine blog has a very interesting brief piece ("Quackbusters") that links to more information about key issues related to the role of the clinical trial and clinical trial registries as one potential solution to address publication bias.

(there's also a great discussion of why there need to be therapeutic trials specifically in children if we're to understand how to treat pediatric conditions, i.e. they can't be treated as if they're just miniature adults - related to a new WHO initiative "Make medicines child sized")