Where Are We in The Battle Against Antibiotic-Resistant Infections?
The article highlights that antibiotic resistance has increased globally, with frontline antibiotics losing effectiveness and one in six bacterial infections now resistant to all known treatments, according to a recent WHO report. In the U.S., antimicrobial-resistant infections cause millions of illnesses and tens of thousands of deaths annually. Progress has been made through stronger infection control and antibiotic stewardship in hospitals, but outpatient prescribing remains a major challenge, with many unnecessary antibiotic prescriptions contributing to resistance. Clinical implications: This trend underscores the need for judicious antibiotic use, rapid diagnostic tools and broader stewardship to preserve current drugs and improve patient outcomes. Full Access: AAMC
Demystifying PANS and PANDAS
Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and its subgroup Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) are characterized by the sudden, dramatic onset of obsessive-compulsive symptoms, tics, eating restrictions and other neuropsychiatric signs following infection or immune triggers. These conditions can be difficult to differentiate from primary psychiatric disorders. Early recognition and multidisciplinary management—including antibiotics for confirmed infections, immunomodulatory therapy in select cases and behavioral interventions like cognitive-behavioral therapy—can improve outcomes and reduce symptom severity. Clinical implications: Clinician should consider PANS/PANDAS in cases of abrupt behavioral change and coordinate with specialists to tailor treatment and support. Increased awareness and education among clinicians are crucial because delayed diagnosis is common and can lead to prolonged impairment for affected children and families. Full Access: Helio
Doxycycline Use in Adolescent Psychiatric Patients and Risk of Schizophrenia: An Emulated Target Trial
Adolescents prescribed doxycycline had an approximately 30–35% lower estimated risk of later schizophrenia compared with those who received other antibiotics. The authors suggest this association might relate to doxycycline’s anti-inflammatory and putative neuroprotective effects during critical periods of brain development. However, because the analysis was observational rather than a randomized controlled trial, it does not establish causality and may be influenced by unmeasured confounders. Clinical implications: These findings raise the possibility that repurposing anti-inflammatory antibiotics—or targeting neuroinflammation more broadly—could become a novel preventive strategy for high-risk youth, but this requires confirmation in prospective clinical trials. Full Access: The American Journal of Psychiatry
Firearm Violence
The JAMA Summit on Reducing Firearm Violence and Harms convened 60 multidisciplinary experts to develop a strategic roadmap aimed at substantially reducing firearm-related injuries and deaths in the United States by 2040. The summit emphasized that firearm harms—including homicide, suicide and unintentional injuries—have profound impacts on individuals, families, and communities, and that solutions must balance public health priorities with constitutional protections for firearm ownership. The resulting report outlines five essential actions for the next five years, including community-focused interventions, responsible use of technology, narrative change around firearm harms, coordinated government and societal efforts, and a research agenda to support evidence-based prevention strategies. Clinical implications: This underscores the importance of health systems and clinicians recognizing firearm violence as a public health issue, integrating violence prevention into care (e.g., safe storage counseling and screening for risk factors), and advocating for evidence-based policies and programs to protect patient and community health. Full Access: JAMA