Communicable

Ahead of World Antimicrobial Resistance Awareness Week (WAAW), Communicable presents a special episode exploring the role of diagnostics within the space of antimicrobial resistance (AMR). Hosts Thomas Tängdén and Annie Joseph are joined by experts Betsy Wonderly Trainor of CARB-X (USA) and Marc Mendelson of Groote Schuur Hospital (South Africa) to discuss how diagnostics can help address the AMR crisis by guiding targeted treatment and reducing unnecessary antibiotic use. They explore the limitations of current diagnostic tools, the challenges of implementing them across different healthcare settings, and the need for incentives to encourage investment in diagnostic innovation. 

In this episode of Communicable, Emily McDonald returns for another ‘Quarterly catch-up’ and is joined by Angela Huttner as co-host. Together, they review four recent randomised clinical trials, focusing on antibiotic treatment duration and different treatment approaches across a range of infections and patient populations [1–4]. They discuss the results and weigh in on their implications for clinical practice.

References

In this episode of Communicable, hosts Emily McDonald and Marc Bonten are joined by Sylvain Lother and Valentijn Schweitzer for a discussion on the use of macrolides in community-acquired pneumonia. Together, they examine the evidence for adding a macrolide to beta-lactam therapy, which patients may benefit from combination treatment, and how available evidence can inform clinical practice.

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Further reading

At the Critical Care Reviews meeting in Belfast in June this year, REMAP-CAP investigators presented results suggesting that oseltamivir may be harmful in critically ill patients with influenza, upending a long-standing clinical practice in intensive care [1]. In this fourth collaboration between SIDP’s Breakpoints and ESCMID’s Communicable podcasts, hosts Erin McCreary and Josh Davis are joined by Steve Webb (Monash University), senior REMAP-CAP investigator and 'godfather of adaptive trial design', and Steve Tong (University of Melbourne), esteemed clinical trialist and friend of both podcasts. Together, they walk through the trial domain’s design, outcomes and results, also highlighting how th...

In this episode of Communicable, Emily McDonald and Josh Davis host Henning Bundgaard and Sami El-Dalati for a discussion on early oral antibiotic switch for endocarditis, focusing on the POET trial, led by Bundgaard, and its clinical impact seven years after the results were first published in 2019 [1]. The episode also covers the ‘prose’ and cons of early oral switch therapy, as well as broader challenges of implementing new evidence in practice when it goes against long-standing dogma.

References

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In this episode of Communicable, Amy Legg (Brisbane, Australia), Rekha Pai Mangalore (Melbourne, Australia) & Angela Huttner (Geneva, Switzerland) return for the third part of the ‘We will make you love PK/PD’ series. The hosts are joined by two experts, Amanda Gwee (Melbourne, Australia) & Sebastian Wicha (Hamburg, Germany), to dive into an important application of PK/PD: model-informed precision dosing (MIPD), and how it allows for more informed, individualised dosing decisions. The episode also covers the open-access educational tools, KidsCalc and TDMx, developed by Gwee and Wicha respectively, and the steps clinicians can take to put MIPD into practice, keep...

In the second edition of 'Quarterly catch-up', CMI Communications editors Emily McDonald and Erin McCreary round-up the biggest news in infectious diseases and review clinical microbiology and infectious diseases studies published in the second quarter of 2026 [1-4]. From Pneumocystis jirovecii pneumonia in solid-organ-transplant recipients to a double-blind randomised controlled trial reporting a new antibiotic for complicated urinary tract infections, Erin and Emily highlight four articles they found particularly noteworthy, and comment on whether the results can and should change clinical practice. 

References

In this episode of Communicable, Nav Narayanan and Thomas Tängdén kick off the first 'Ask me anything' episode, inviting EUCAST and CLSI leadership Sören Gatermann, Christian Giske and Amy Mathers to answer questions from our listeners. Together, they discuss the roles and operations of both organisations, similarities and differences between EUCAST and CLSI, how breakpoints and guidance documents are developed, set the record straight about the 'I' category, explain which data inform breakpoint decisions, and much more.

This episode was edited by Communicable's executive producer, Angela Huttner.

Further reading

Do...

In this episode of Communicable, Angela Huttner and Josh Davis are joined by Brett Mitchell, Aline Wolfensberger and Lauren Clack to discuss the HAPPEN trial to prevent hospital-acquired pneumonia led by Mitchell--and the important studies leading up to it [1-3]. The episode also explores trial designs used in their research that are both creative and practical, such as stepped-wedge and implementation trials, and how these approaches can bridge the gap between research and real-world practice.

References

In this episode of Communicable, Thomas Tängdén and Rekha Pai Mangalore return for part 2 of the ‘We will make you love PK/PD’ series. In this round, they are joined by Iris Minichmayr (Austria) and Phil Selby (Australia) for a deep dive into how PK/PD data and principles can be used as integral clinical tools to support dosing decisions. They break down technical concepts of pharmacometrics such as population PK models, Monte Carlo simulations, probability of target attainment (PTA), and cumulative fraction of response (CFR), helping to make these approaches more accessible to everyday clinical practice.

T...

In this episode of Communicable, Emily McDonald and Josh Davis are joined by Roger Lewis (USA) and Ian Marschner (Australia) to compare and contrast Bayesian and frequentist statistical approaches. The panel discusses the fundamental principles of both methods, common misconceptions, and the extent to which they are often more similar than many realise. Together, they explore their use in clinical trial design, analysis, and reporting, including adaptive trials and sequential learning. Additional topics include sample size misconceptions, regulatory versus clinical thresholds, and the challenges of interpreting post hoc reanalyses of negative trials.

This episode was edited...

In this bonus episode of Communicable, hosts Anne-Grete Märtson and Angela Huttner invite Martin Grobusch (University of Amsterdam; ESCMID Emerging Infections Subcommittee) and Daniel Bausch (National University of Singapore, London School of Hygiene & Tropical Medicine, and Geneva Graduate Institute) to discuss the Bundibugyo ebolavirus outbreak currently ongoing in the Democratic Republic of Congo and Uganda. Clinical and virological differences between Bundibugyo and Zaire ebolaviruses are discussed, as are the particular challenges for diagnosis, treatment, and prevention confronting healthcare workers of this outbreak. The episode accompanies two new publications in CMI Communications and CMI:

Our editors – Marc Bonten, Erin McCreary, Anne-Grete Märtson, Angela Huttner, and Josh Davis – are back for part two of the ESCMID Global Late Breakers series, summarising five more late-breaking trials presented at ESCMID Global 2026. They discuss the trials' strengths and weaknesses, and whether their results should change practice. 

The five trials presented in this half of the series are listed below, and links to their respective sessions can be watched and rewatched on the ESCMID Global Virtual Platform. Links to corresponding abstracts and publications where available are provided as well.

Conflict of interest/involvement in the...

The ESCMID Global Late Breakers series returns to Communicable! Five CMI Communications editors – Marc Bonten, Josh Davis, Angela Huttner, Anne-Grete Märtson, and Erin McCreary – handpicked five late-breaking trials presented at ESCMID Global 2026 to summarise their  findings and discuss whether the results will change their practice. This is part one of the two-part series. 

Trials presented are listed below and links to their respective sessions can be watched and rewatched on the ESCMID Global Virtual Platform. Links to corresponding publications, if available, and mentioned related articles are provided as well.

The FAST trial (Late-breaking research from JA...

In this collaborative episode of Breakpoints and Communicable, the hosts revisit the “trial run” session from ESCMID Global, a format designed to facilitate critical discussion of major infectious diseases trials. This episode focuses on two studies addressing bloodstream infections caused by third‑generation cephalosporin-resistant Enterobacterales [1].

Mical Paul (Rambam Health Care Campus, Israel) joins the podcast to discuss the PETER PEN trial [1,2], comparing piperacillin/tazobactam with meropenem, including its design, interim analyses, and interpretation alongside prior data such as MERINO. The episode also features Jesús Rodríguez‑Baño (University of Seville, Spain), who presents a post hoc analysi...

This is a short message to Communicable listeners to inform them that the next episode will be released on Friday, 8 May, as it is a collaboration episode with Breakpoints, the podcast of the Society of Infectious Diseases Pharmacists. It will cover the two trials presented in Munich during ESCMID Global's late-breaker Trial Run session.

Communicable is launching a new series on everything related to pharmacokinetics (PK) and pharmacodynamics (PD). Kicking off this series are hosts Thomas Tängdén, Erin McCreary and Angela Huttner, and invited guests Amy Legg and Rekha Pai Mangalore. They walk us through key parameters and terms of PK/PD, such as volume of distribution, minimum inhibitory concentration (MIC), epidemiological cut-off value (ECOFF), and PK/PD indices, laying the foundation to better comprehend clinical applications such as setting a clinical breakpoint and how it guides therapeutic drug monitoring (TDM). This first episode encompasses a broad scope across PK/PD th...

This is the first episode of the 'Quarterly catchup' series, in which CMI Communications editors discuss important and useful articles that have come out in the last 3 months to understand their results and potential clinical impact. In this inaugural episode of 'Quarterly catchup', Emily McDonald (Canada), Thomas Tängdén (Sweden) and Navaneeth Narayanan (USA) convene to discuss clinical microbiology and infectious diseases studies published in the first quarter of 2026 [1-6]. From Wolbachia-infected mosquitoes reducing dengue infection to exploration of antibiotic combination therapies against multidrug-resistant organisms, our hosts summarize six articles they found the most interesting, and discuss whether th...

In this episode of Communicable, hosts Angela Huttner and Marc Bonten invite two members of the ESCMID Emerging Infections Subcommittee, Martin Grobusch (Amsterdam, Netherlands) and Pikka Jokelainen (Copenhagen, Denmark), to discuss infectious disease outbreaks. Sparked by the Subcommittee's beloved 'Epi Alert', which identifies and tracks outbreaks around the world, the episode covers common missteps and underestimated challenges in handling new outbreaks, the effects of climate change, and what 'One Health' really means. 

This episode was peer reviewed by Ummu Afeera Zainulabid of the International Islamic University Malaysia, Kuantan, Malaysia.

Further reading

Yesterday was International Women's Day. In light of that, Communicable prepared a special episode in which hosts Erin McCreary and Annie Joseph are joined by Esmita Charani (South Africa) and Annette Westgeest (Netherlands) for a discussion on gender- and sex-dependent patient-care disparities in the infectious diseases space. Together they review recent research findings that identified gender and sex as important determinants influencing patient outcomes and even decision making by prescribers. They also explore how societal and cultural norms may introduce further nuance and complexities. The panel remains optimistic in reaching equal healthcare for all, reflecting also on progressive steps...

In this third collaboration between SIDP’s Breakpoints and ESCMID’s Communicable podcasts, hosts Erin McCreary and Angela Huttner invite two veteran authors of guidelines and guidances, Pranita Tamma (Philadelphia, USA) and Benedikt Huttner (WHO, Geneva, Switzerland) [1-3]. Together, they deconstruct the complex landscape of developing and implementing guidelines into digestible components: they discuss why different organizations develop guidelines and what need they hope to fulfil, the framework including the GRADE methodology under which guidelines are written, and major barriers in the uptake of guidelines. The conversation also details the distinction between guideline and guidance as well as the art...

In this episode of Communicable, Navaneeth Narayanan and Josh Nosanchuk invite Virginie Lemiale and Elie Azoulay (Paris, France) as well as fellow editor Emily McDonald (Montreal, Canada)—this time as guest—to discuss adjunctive steroid therapy for pneumocystis pneumonia (PCP) in HIV-negative individuals. In 2025, Lemiale and Azoulay published results from their double-blind, randomised controlled trial investigating steroid treatment for severe Pneumocystis jirovecii pneumonia (PIC trial) in the Lancet Respiratory Medicine [1]. At first glance, one might dismiss the study’s clinical impact due the ‘negative' result of  the primary outcome, mortality at 28 days, which just missed a statistically significant difference between g...

In this episode of Communicable, Josh Davis (Newcastle, Australia) and Emily McDonald (Montreal, Canada), plus invited guest, Steven Tong (Melbourne, Australia)—all practicing physicians and clinical trialists—assemble to discuss some of their ‘top infectious diseases papers published in 2025’. Bassam Ghanem (Jeddah, Saudi Arabia), whom one might know better as Antibiotic Steward on social media, was also invited to share his favourite publications of 2025.

Six papers that were most consistently picked by the panel are presented, explaining why they were picked and how they have shifted paradigms or changed their practice. This episode complements the previous episode, which pr...

In the first Communicable episode of 2026, Annie Joseph and Josh Nosanchuk invite Robin Patel (Rochester, USA) and Fidelma Fitzpatrick (Dublin, Ireland) to discuss some of their favourite clinical microbiology papers published in 2025. These six papers highlight everything from technological advances of genomics and molecular diagnostic testing to the importance of patient and public involvement in research as well as effective communication [1-6]. The panel also discusses whether or not any of these papers have changed their practice.

This episode was edited by Kathryn Hostettler and peer reviewed by Sinéad Kilgarriff of the National Virus Reference Laboratory U...

In this final episode of 2025, hosts Annie Joseph (Nottingham, UK) and Angela Huttner (Geneva, Switzerland), interview Communicable's producer, Katie Hostettler-Oi (Zurich, Switzerland), to learn which episodes she liked best this year. Their discussion provides a behind-the-scenes look at some of the episodes--including the strange surprises that sometimes came with them. Finally, the CMI Comms editors and editorial fellows send in their perspectives on 2025 and their wishes for 2026.

During the COVID-19 pandemic with lockdown mandates and social distancing, doctors, researchers, and the public were able to find refuge and community online; for the infectious disease community, it was on the social media platform Twitter, and more specifically under the widely used hashtag, #IDTwitter. Under new ownership from 2022, however, Twitter’s name and brand changed to what we now know as X, and “the heyday of #IDTwitter is long since gone”. In this special episode of Communicable, Angela Huttner and Marc Bonten invite doctors and science communicators, Neil Stone (London, UK), Ilan Schwartz (Durham, USA), and Tara Smith (Kent...

In the last ten years, 'diagnostic stewardship' has emerged as a core principle of good clinical practice whose implementation impacts both the individual patient and public health at large. In this episode of Communicable, hosts Angela Huttner and Annie Joseph invite two experts in the field, Daniel Morgan (Maryland, USA) and Valerie Vaughn (Utah, USA), to discuss diagnostic stewardship in the context of infectious diseases, hospital medicine, and healthcare in general. Other topics covered include practical interventions for better testing practices and the role of artificial intelligence in the future of diagnostics. The episode highlights how thoughtful, intentional diagnostic...

It’s World AMR Awareness Week (WAAW) and we have prepared a special episode in light of that. In this week's Communicable, Navaneeth Narayanan and Thomas Tängdén host Aula Abbara (London, UK), Guido Granata (Rome, Italy) and Tuomas Aro (Helsinki, Finland) to discuss the phenomenon of AMR in conflict and crisis zones. They elaborate on how difficult conditions and austere environments amplify the spread of AMR, drawing on findings from the ongoing conflicts in Ukraine, Gaza, Syria and other regions. Other topics covered include adapting antimicrobial stewardship and infection prevention and control (IPC) practices as well as the...

Once confined to the tropics, dengue is spreading via its vector, the Aedes mosquito, to more temperate regions, causing increases in global morbidity, mortality and cost. In 2019, the WHO recognised dengue as one of the top ten global health threats alongside climate change and antimicrobial resistance [1]. In this episode of Communicable, Annie Joseph and Nav Narayanan welcome two dengue experts, André Siqueira of the non-profit Drugs for Neglected Diseases Initiative based in Geneva, Switzerland (Rio de Janeiro, Brazil), and Steven Lim of the Raja Permaisuri Bainun Hospital (Ipoh, Malaysia). Together, they discuss the epidemiology, clinical presentation and management of d...

In this episode of Communicable, Erin McCreary and Angela Huttner are joined by Barbara Trautner (St. Louis, USA) and Valéry Lavergne (Vancouver, Canada), the co-chairs and leading authors of the first IDSA guideline on complicated urinary tract infection (cUTI), which was published a few months ago [1]. Together, they discuss the process of developing the guideline from its conception in 2018, the new definition of cUTI, their stepwise approach to clinical decision-making, and some case-by-case scenarios for common antibiotics. They also elaborate on how this guideline compares (and contrasts) to other existing UTI guidelines—including the previous IDSA guideline for UTI...

Contrary to popular belief, peer review has only recently become an integral step in scientific publishing. Currently seen by many as a badge of honour ensuring valid, innovative and honest research, peer review seems in reality to be increasingly thankless, exploitative, and sometimes invisible. How did we get here? In this episode of Communicable, Annie Joseph and Angela Huttner are joined by two experts, Melinda Baldwin (University of Maryland, USA) and Serge Horbach (Radboud University, Netherlands), to unpack and examine the role of peer review, why it is still essential, and how it fits within the greater editorial process...

In this second-ever collaboration between SIDP’s Breakpoints and ESCMID’s Communicable podcasts, hosts Erin McCreary and Angela Huttner invite the two principal investigators and visionaries who spearheaded the Bacteraemia Antibiotic Length Actually Needed for Clinical Effectiveness (BALANCE) trial, Nick Daneman and Rob Fowler (Sunnybrook Health Sciences Centre, Toronto), for a “deep dive into all things that went into this trial” (1). The BALANCE trial spanned over ten years investigating - as the acronym title suggests - whether a shorter treatment duration of seven days was non-inferior to the standard of care of fourteen days for bacteraemia. The conversation covers everythi...

In this episode of Communicable, Angela Huttner and Erin McCreary invite two titans of vaccinology, Barney Graham (Atlanta, USA), former deputy director of the NIH NIAID Vaccine Research Center and architect of the mRNA vaccines against COVID-19, and Gary Kobinger (Galveston, USA), leading virologist in the development of the first effective Ebola vaccine, rVSV-ZEBOV, for a candid conversation about their direct experience building two of the most well known vaccines to date, and deploying them to the public. The episode also reviews the different vaccine platforms and addresses vaccine hesitancy, equitable access to vaccines, and global health equity. 

Fungal infections and disease have long been overlooked in terms of healthcare burden, with poor diagnostics and limited options for treatment and management. In 2022, the WHO published its first Fungal Priority Pathogens List as an effort to establish a global prioritised framework that addresses unmet research and development needs in fungal disease and antifungal resistance, as well as guides public health action [1]. In this episode of Communicable, Angela Huttner and Josh Nosanchuk invite Hatim Sati (WHO), the project lead in creating this list, and Dimitrios Kontoyiannis (MD Anderson Cancer Center, Houston, Texas), a clinician researcher studying fungal diagnostics and...

Ethics in the field of infectious disease can be a delicate interplay between treating the individual patient and protecting the collective health of a society. Sometimes these two mandates go hand in hand; at other times they can appear to be in conflict. In this episode of Communicable, Dr. Angela Huttner invites Drs. Zeb Jamrozik (Melbourne, Australia) and Beenish Syed (Karachi, Pakistan), two members of ESCMID’s Ethics Advisory Committee, to unpack different scenarios encountered in the field of infectious disease from an ethics standpoint: how one ethically allocates scarce resources like antimicrobials; whether there is ethical justification for co...

Fluoroquinolones (FQs) are valuable given their broad-spectrum activity against Gram-positive and Gram-negative bacteria and their high penetration into various tissues. Yet FQs have also caused concern, with some market withdrawals, important and sometimes long-lasting adverse drug events, and substantial collateral effects on the microbiota. In this episode of Communicable, hosts Emily McDonald and Thomas Tängdén invite Staffan Tevell (Karlstad, Sweden) and Bernadette Young (Oxford, UK) to weigh in on the pro-con debate of FQ use, especially for periprosthetic joint infections (PJIs), which can entail longer treatment durations. They review the standard of care for PJIs, including FQs in...

The adaptability of fungi to warmer temperatures is an obvious consequence of climate change. Perhaps less obvious is the role climate change has played on fungal pathogens emerging as a global health concern. While humans are mostly protected from fungal infections by our immune system and body temperature, a warming global climate could subvert the status quo. Some fungi are already adapted to warmer temperatures and causing invasive acute infections in humans: Candidozyma auris, Cryptococcus neoformans, and Aspergillus fumigatus, to name a few.  In this episode of Communicable, Angela Huttner and Josh Nosanchuk invite Arturo Casadevall, a Bloomberg Distinguished P...

Meningitis remains a major global health threat, with an estimated 2.5 million cases each year; of these, one in six results in death and one in five in long-term disabilities. Although meningitis “can strike anyone, anywhere in the world,” outbreaks disproportionately impact low- and middle-income countries, where diagnostic and treatment resources are limited. In efforts to address this, WHO launched its first-ever guideline on meningitis diagnosis and management in April this year. In this episode of Communicable, hosts Emily McDonald and Marc Bonten are joined by two experts directly involved in creating the guideline, Lorenzo Pezzoli and Nicolò Binello (WHO), as we...

Bacterial vaginosis (BV) was long considered not to be a sexually transmitted infection (STI), and treatment was only for women to bear. That was the convention at least until Catriona Bradshaw and her team at the Melbourne Sexual Health Centre published their groundbreaking clinical trial results earlier this year, demonstrating that treating male partners of women with BV prevented recurrence in those women. In this episode of Communicable, hosts Angela Huttner and Annie Joseph welcome back Bradshaw to discuss her trial’s design, results, and clinical implications—with some guidelines already updated to include male partners in BV treatment regi...

Editors of CMI Comms, Josh Davis, Erin McCreary and Emily McDonald return for round 2 taking turns to summarise and discuss late-breaker trials presented at ESCMID Global 2025 in Vienna, and whether or not these trials should change your practice. Part 2 covers the ALABAMA trial exploring the safety of penicillin-allergy delabelling using the penicillin allergy assessment pathway, the SOLARIO trial investigating short (≤7 days!) versus long (≥4 weeks) antibiotic courses for orthopaedic infections, the EAGLE-1 trial assessing oral gepotidacin for gonorrhoea, a randomised clinical trial (RCT) from Thailand on oral fosfomycin as carbapenem-sparing, de-escalating therapy in complicated UTIs, and a double-blind RCT from Isra...