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Since it's World Antibiotic Awareness Week, let's revisit the recent article in which Llewelyn et al. convincingly argue that it's time to drop the message that not finishing a course of antibiotics contributes to resistance. Because it's incorrect

#WAAW
bmj.com/content/358/bm…
I once tried to track down the origins of this idea. I found dozens of papers claiming it, citing others, which cited others, and every chain went back to one source: Fleming's conjecture at his Nobel speech. Neither theory nor evidence support it.
From my reading of the sources, much of the original idea was the correct idea that marginally lethal doses of antibiotic could promote resistance (which is certainly true) but that this got conflated with the length of course at a fixed high dose, which is different
Read 9 tweets
#AntibioticResistance is a global health threat. As such it requires global collaboration and also action across sectors. However some of the biggest challenges are difficult to address because they are our old structural issues...
The availability of quality diagnostics and the
Availability of well trained human resources for health are KEY for fighting resistance.
Without diagnostics it's very difficult to understand the burden and patterns and we do not cure what we can't see.
And without HRH we can't implement the AMR Pillars.
Therefore....
At least for the human component,
It is to a great extent, an ACCESS to care issue.
We need to invest in health systems and to tackle all access barriers for everyone. Remember when we talk about infectious diseases No one is safe until everyone is safe.
#StopSuperbugs
#WAAW
Read 4 tweets

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