UCL Discovery is UCL's open access repository, showcasing and providing access to UCL research outputs from all UCL disciplines.

Communicable takes on a two-part series covering selected clinical trials presented at ESCMID Global 2025. Editors of CMI Comms, Marc Bonten, Josh Davis, Erin McCreary, and Emily McDonald, all clinical trialists in their own right, take turns to summarise and discuss late-breaker trials presented at ESCMID Global 2025 in Vienna. Part 1 includes the CloCeBa trial on Staphylococcus aureus bacteraemia treatment options, the Taper V trial on vancomycin as prevention of recurrence of Clostridioides difficile infection, the ASTARTÉ trial on temocillin versus meropenem for bacteraemia due to third-generation cephalosporin-resistant Enterobacterales, the HARVEST trial investigating high doses of rifampicin for tuberculosis meningitis, and the CAP5 trial on shortening antibiotic treatment for community-acquired pneumonia.The editors Davis, McCreary, and McDonald return for part 2 to discuss more late-breaker trials and whether or not these trials should change your practice. Part 2 covers the ALABAMA trial exploring the safety delabelling of antibiotic prescribing via the penicillin allergy assessment pathway, the SOLARIO trial investigating short and long antibiotic regimens in orthopaedic infection, the EAGLE-1 trial on gepotidacin to treat uncomplicated gonorrhoea, a randomised controlled trial (RCT) from Thailand on oral fosfomycin as a carbapenem-sparing, de-escalating therapy in complicated urinary tract infections (UTIs), and a double-blind RCT from Israel on neutralising plasma versus placebo for patients with West Nile fever.Part 1 was peer reviewed by Barbora Píšová from the Czech Republic and part 2 by Emanuele Rando of Hospital Universitario Virgen Macarena, Seville, Spain. Part 1 was released on 19 May 2025 and part 2 on 2 June 2025.Late-breaker trials, part 1•Lescure X, et al. Cloxacillin versus cefazolin for methicillin-susceptible Staphylococcus aureus bacteraemia (CloCeBa): a randomised controlled noninferiority trial•McDonald EG, et al. Initial vancomycin taper for the prevention of recurrent Clostridioides difficile infection: the TAPER-V randomised controlled trial•Cogliati Dezza F, et al. Temocillin versus meropenem for the targeted treatment of bacteraemia due to third-generation cephalosporin-resistant Enterobacterales (ASTARTÉ): a randomised pragmatic trial•Van Crevel R, et al. High-dose rifampicin in the treatment of tuberculous meningitis: results of the HARVEST phase III multi-country randomised clinical trial•Bastrup Israelsen S, et al. Shortened antibiotic treatment for 5 days in patients hospitalised with community-acquired pneumonia (CAP5): a multicentre randomised controlled noninferiority trialLate-breaker trials, part 2•Sandoe J, et al. Penicillin allergy assessment pathway versus usual clinical care for primary care patients with a penicillin allergy record to assess safety, delabelling and antibiotic prescribing: The ALABAMA randomised controlled trial•Angkanavisan K, et al. Oral fosfomycin after carbapenems as de-escalating therapy in complicated urinary tract infection: A randomised controlled trial•Canetti M, et al. Neutralising plasma versus placebo for hospitalised patients with West Nile fever: a double-blind randomised controlled trial•Dudareva M, et al. Short or long antibiotic regimes in orthopaedics: the SOLARIO multicentre randomised controlled trial•Wilson, J. Phase 3 randomised trial of oral gepotidacin for the treatment of uncomplicated gonorrhoea (EAGLE-1)Declaration of competing interestOf the trials presented or discussed in these episodes, E.G.M. is the principal investigator of the Taper V trial and J.S.D. is a coordinating investigator of the SNAP trial. E.G.M. and M.B. serve on the GTSC for the SNAP trial. E.K.M. serves on the DSMC for the SNAP trial and has previously served on scientific advisory boards for the following pharmaceutical companies: Abbvie, Basilea, Melinta, and GSK. K.H. declares no financial interests/personal relationships that may be considered as potential competing interests.Related podcast episodes•Communicable episode 27: Late-breaker trials at ESCMID Global: Should they change your practice? - part 1 https://share.transistor.fm/s/4d33aa77.•Communicable episode 28: Late-breaker trials at ESCMID Global: Should they change your practice? - part 2 https://share.transistor.fm/s/4f044e8c.Further reading•IDSA. Public Comment: IDSA Guideline on Management and Treatment of Complicated Urinary Tract Infections; 19 Feb - 19 March 2025.•Mostashari F, Bunning ML, Kitsutani PT, Singer DA, Nash D, Cooper MJ, et al. Epidemic West Nile encephalitis, New York, 1999. Lancet. 2001;358:261−4. DOI:https://doi.org/10.1016/S0140-6736(01)05480-0.•Angus DC. Optimizing the trade-off between learning and doing in a pandemic. JAMA. 2020;323:1895−6. DOI:https://doi.org/10.1001/jama.2020.4984.•Dudareva M. In: The 42nd annual meeting of the European bone & joint infection society. Barcelona, Spain; September 26-28, 2024.•Li H-K, Rombach I, Zambellas R, Walker S, Mc Nally MA, Atkins BL, et al. Oral versus intravenous antibiotics for bone and joint infection (OVIVA). N Engl J Med. 2019;380:425−36. DOI:https://doi.org/10.1056/NEJMoa1710926.

The infection is responsible for 800,000 newborn deaths each year, but clinics in eight countries are working together to find new treatments

Periprosthetic joint infections (PJI) caused by <i>Enterococcus</i> spp., especially vancomycin-resistant strains (VRE), are challenging to treat due to biofilm tolerance and limited antibiotic options. Bacteriophages offer a promising adjunct through targeted and biofilm-disrupting activity. This s …

The Trial Talk podcast explores how our work at the MRC Clinical Trials Unit at UCL is improving health in the UK and worldwide. In this series, we hear from world-leading experts about the studies we

Fosfomycin sodium injection (brand: Sanjing®) is a phosphonic acid antibiotic manufactured by Harbin Sanjing Pharmaceutical (NMPA No.?H19999109; Code?86903705001542), supplied as 1?g sterile vials (10 vials/box, barcode?6930579900569). It offers broad-spectrum activity against Gram?positives and negatives, ideal for in vitro and in vivo infection models. Strictly for laboratory research use?Please consult the staff for other purposes?

BackgroundFosfomycin combined with other antibiotics is often used to treat Pseudomonas aeruginosa infections. In this study, we investigated the effects of ...

The intravenous formulation of fosfomycin has a novel mechanism of action an no known cross-resistance to other antibiotic classes.

The federal agency gave the nod to Meitheal Pharmaceuticals for its antibiotic, Contepo, an intravenous fosfomycin offering a new mechanism of action and a new option for adults with complicated urina...

The federal agency gave the nod to Meitheal Pharmaceuticals for its antibiotic, Contepo, an intravenous fosfomycin offering a new mechanism of action and a promising option for adults with complicated...

The efficacy of fosfomycin is increasingly challenged by emerging resistance mechanisms, primarily involving fosfomycin-modifying enzymes and target (MurA) alterations. This study aimed to elucidate t...