Thursday, January 10, 2013

Thank You!

It has come to my attention that many of you think that since I am accepting no new clients and I am shutting down my website, this blog will also disappear.  Nothing could be further from the truth.  Just because I am trying to cut down on my workload does not mean that I intend to shut up!

In this beginning of 2013, I thought I would take time out from more serious matters to express my thanks.  First, I am surprised and honored by the number of you who actually read this blog.  Since its inception in May, 2008, the blog has received over 80,000 views half of which come from outside the US.   I am staggered at this level of interest in antibiotics and what I have to say about the subject.

I want to express my special thanks to a number of individuals who have contributed to the blog over the years including Brad Spellberg, Paul Ambrose, George Drusano, David Livermore, Lynn Silver, Lew Barrett and others.  Without your help, this effort would be much less interesting and, apparently, effective.

I also have to thank many of you with whom I have argued, debated, whom I have cajoled, pushed and to whom I have otherwise been unpleasant.  I am grateful for the opportunity to speak with you, exchange ideas and even have you listen to my point of view. 

Included in this group are those of you at the FDA who answer my questions on policy and guidance, patiently listen to my dissenting (sometimes sharply) viewpoints and yet are always respectful, polite and seemingly interested nevertheless.  I am also grateful for the opportunity you have given me to interact with you at the Gordon Research Conference, the Brookings Institution and the Pew Charitable Trust. I know that you know how much I fervently support the concept of an effective FDA and I know that you take what I say in the spirit of “tough love” in which it is meant.  I am grateful that you still speak with me.

Now – a little feedback for you.  The most popular blogs of all time –

The FDA and Community Acquired Pneumonia from October, 2011 – 3463 views.
This is a little unfortunate since there have been several updates (even though there is still the problem of prior antibiotic use).

Rebooting Hospital Acquired Pneumonia from August, 2012 – 2850 views.
This blog contains my proposal for a feasible and scientifically justified non-inferiority design for HAP/VAP trials.

Antibiotics in 2012 from December, 2011 – 2830 views.
This was my set of predictions for 2012 – recently revisited at

Antibiotic Markets and SPLU (Guest blogger Lew Barrett) – 2141 views
Here Lew tried to make market predictions for an imaginary drug specifically targeting resistant strains of Acinetobacter.

Telavancin, Astellas and Theravance – January, 2012 – 1291 views.
This blog was about the effect of FDA waffling coupled with antibiotics of limited spectrum and manufacturing issues on the business prospects of biotech using the Theravance-Astellas deal on telavancin as the example.

Other highly popular blogs included the report on Pfizer abandoning antibiotic R&D in November 2011, my review of the avibactam posters at ECCMID in 2011, my piece on antibiotic breakpoints, the FDA, CLSI and EUCAST (followed later by a more authoritative piece by David Livermore), and finally my report of Janet Woodcock’s announcement of the FDA reboot in May, 2012.

Coming soon – the next installment in the continuing series of antimicrobial discovery grant writing.

Have a great year!


  1. Dr Shales -

    I read your blog every time I see a new hit in the RRS feed. Thank you for your wonderful work.

    As an antibiotic researcher (until funding cuts) I feel it is vital there is a voice out there speaking truth to power on this issue.

    I am curious your take on the current reduction/loss of public health departments nation-wide at a time when we are seeing whooping cough and measles epidemics. The former, in my home-state of WA, is so critical and the staffing levels so low they treat and street without definitive tests which seriously concerns me.

    Best wishes, MT Hough

  2. Hello. Thanks for your comment. Clearly our public health infrastructure should be a priority for government - local as well as national. During the bioterror scares of the previous decade we made good progress in this area - but still not enough. Even that is now threatened by state and local budget cuts. This is one of those ares where federal dollars could help. But given the paralysis of government (caused by republicans in the house in my view) - I'm not sure where we will end up.