Archive for September 12, 2015

Antimicrobial therapy in obesity: a multicentre cross-sectional study

Journal of Antimicrobial Chemotherapy Oct 2015 V.70 N.10 P.2906-2912

Esmita Charani, Myriam Gharbi, Gary Frost, Lydia Drumright, and Alison Holmes

1National Institute of Health Research Health Protection Research Unit, Imperial College London, Hammersmith Campus, London W12 ONN, UK

2Department of Medicine, Imperial College London, Hammersmith Campus, London W12 0NN, UK

3Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 0QQ, UK


Evidence indicates a relationship between obesity and infection. We assessed the prevalence of obesity in hospitalized patients and evaluated its impact on antimicrobial management.


Three National Health Service hospitals in London in 2011–12 were included in a cross-sectional study. Data from all adult admissions units and medical and surgical wards were collected. Patient data were collected from the medication charts and nursing and medical notes. Antimicrobial therapy was defined as ‘complicated’ if the patient’s therapy met two or more of the following criteria: (i) second- or third-line therapy according to local policy; (ii) intravenous therapy where an alternative oral therapy was appropriate; (iii) longer than the recommended duration of therapy as per local policy recommendations; (iv) repeated courses of therapy to treat the same infection; and (v) specialist advice on antimicrobial therapy provided by the medical microbiology or infectious diseases teams.


Of the 1014 patients included in this study, 22% (225) were obese, 69% (696) were normal/overweight and 9% (93) were underweight. Obese patients were significantly more likely to have more complicated antimicrobial therapy than normal/overweight and underweight patients (36% versus 19% and 23%, respectively, P=0.002). After adjustment for hospital, age group, comorbidities and the type of infection, obese patients remained at significantly increased odds of receiving complicated antimicrobial therapy compared with normal/overweight patients (OR=2.01, 95% CI 1.75–3.45).


One in five hospitalized patients is obese. Compared with the underweight and normal/overweight, the antimicrobial management in the obese is significantly more complicated.



September 12, 2015 at 10:33 pm

Teixobactin, the first of a new class of antibiotics discovered by iChip technology?

Journal of Antimicrobial Chemotherapy Oct 2015 V.70 N.10 P.2679-2680

Laura J. V. Piddock*

Antimicrobials Research Group, Institute of Microbiology and Infection, University of Birmingham, Birmingham B15 2TT, UK E-mail:

Teixobactin is a recently described antibiotic of a new class produced by a hitherto undescribed soil microorganism (provisionally named Eleftheria terrae). It was isolated with a new tool, the iChip, that allowed the environmental bacterium to grow and for the antibiotic it produced to be isolated and subsequently identified.

Teixobactin has activity against Gram-positive (but not Gram-negative) organisms and mycobacteria and a novel mode of action inhibiting peptidoglycan biosynthesis.

In vitro no teixobactin-resistant Staphylococcus aureus or Mycobacterium tuberculosis were selected. In experimental infections of MRSA and Streptococcus pneumoniae in mice, teixobactin was effective at reducing the bacterial load.

Although teixobactin is at an early stage of development and there are no guarantees it will make it to market, the use of the iChip will hopefully result in the discovery of further potential new antibiotics.


September 12, 2015 at 10:31 pm


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