“PSI Foundation support enabled us to better understand the impact of antibiotic treatment duration for bacteremia on the gut microbiome and antimicrobial resistance, and has helped us develop an ongoing clinical trial microbiome substudy pipeline which will continue to uncover important off-target effects of antibiotics on microbiomes and antimicrobial resistance in humans.”
-Dr. Nick Daneman
About Dr. Nick Daneman
Dr. Nick Daneman is a Clinician Scientist and Division Head of Infectious Diseases at the Sunnybrook Research Institute, Senior Adjunct Scientist at ICES, and a Professor of Medicine at the University of Toronto. He specializes in Trauma, Emergency, and Critical Care. Dr. Daneman’s research focuses on antibiotic stewardship and resistance; hospital-acquired and critical care infections; with a specific focus on Clostridium difficile and bacteremia. His training began at University of Toronto, where he completed his masters in Clinical Epidemiology and later completed his medical training with a specialty in Infectious Diseases and Internal Medicine.
About the Funded Study
With his research team, Dr. Daneman set out to address the healthcare needs of patients who needed to consume antibiotics to fight off infection, while facing the off-target effects of antibiotic resistance and potential damage to one’s microbiome and the healthy bacteria in the body. The ‘BALANCE of the microbiome’ study enrolled over 3,600 participants worldwide — the first to embed a microbiome and antimicrobial resistance outcome in a large international clinical trial of an antimicrobial stewardship intervention.
The results of the randomized controlled trial revealed that for those who need to take antibiotics to treat blood infections, 7 days of taking antibiotics was just as effective as 14 days — reducing the potential damage caused by long-term antibiotic use.
“PSI Foundation support has directly informed ongoing clinical trial and microbiome substudy design, in particular in trials designed and initiated by this group, such as the BALANCE+ platform and ARODECAMP trials,” Daneman says. “Our goal is to continue to embed microbiome and antimicrobial-resistance assessments into clinical trials, to determine not only the clinical outcomes of study comparisons, but also their biological effects.”
Impact of the Funded Study
Moving forward, this PSI-funded study allowed Dr. Daneman’s team to develop a platform for future microbiome substudies of large international trials, including the ongoing BALANCE+ adaptive platform trial of bacteremia.
“Our goal is to develop and implement the methods required for microbiome analyses in clinically-actionable time for scenarios where microbiome and resistance status can inform clinical decisions.“
The implications of this study for Ontarians are major reductions in antibiotic treatments and harms across Ontario. With the data from this research, Dr. Daneman’s final goal is to incorporate microbiome and resistome considerations into clinical and stewardship practices in infectious disease by generating the data required to do so from human studies.
