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Forecasts the clinical services management for infectious diseases in Europe. Characteristics of infectious disease specialist; Emphasis on the implementation of good hospital hygiene; Discussion of the challenges in the field of diagnostic microbiology.

Background: With the best prophylactics now available, venous thromboembolism after total knee replacement remains substantial (25% to 27%). Recombinant nematode anticoagulant protein c2 (rNAPc2) is a potent inhibitor of factor VIIa/tissue factor complex that has the potential to reduce this risk. The present study was performed to determine an efficacious and safe dose of rNAPc2 for prevention of venous thromboembolism after elective, unilateral total knee replacement., Methods and Results: This open-label, sequential dose-ranging study was conducted in 11 centers in Canada, Europe, and the United States. Five regimens were tested. Injections were administered subcutaneously on the day of surgery (day 1) and days 3, 5, and optionally, day 7. Primary efficacy outcome was a composite of overall deep vein thrombosis based on mandatory unilateral venography (day 7+/-2) and confirmed symptomatic venous thromboembolism recorded

A group of experts met under the auspices of the European Science Foundation, the European Medical Research Council and the European Society of Clinical Microbiology and Infectious Diseases to discuss formulation of a European strategy on the control of antibiotic resistance in Europe. This is a report of the meeting which was used as the basis for a European Commission grant application. The need for a common strategy to make best use of scarce resources was agreed and it was concluded that the first stage (discussed in this article) is to collate existing data on resistance rates, antibiotic consumption, antibiotic stewardship, infection control and molecular typing methods. Consensus reached from analysis of these data can direct us to the most appropriate controlled trials. While it is accepted that there is a widely held perception that the medical profession has been slow to react to the problem of antibiotic resistance, much more work still needs to be carried out before we can recommend, implement and trial definitive control measures. In the meantime, however, all reasonable efforts should be made to reduce antibiotic consumption without compromising patient care, establish cost-effective surveillance systems using existing laboratory generated data, improve hygiene in our hospitals and better define the molecular basis of antibiotic resistance.