“Always finish your antibiotics” is no longer considered medical best practice for all conditions. This may come as a surprise for many patients.
A new study has found that almost 90% of Americans believe that it’s always best to take the full course of antibiotics, even when you feel better – consistent with long-running but now outdated health campaigns. The reality is more complicated. Sometimes shorter courses are safer, and sometimes longer courses are best.
The survey demonstrates a need for better communication between doctors and patients about what’s healthiest.
“Historically, there was very strong guidance by major health organisations and clinicians that you must always finish the course,” says Alistair Thorpe, PhD, research assistant professor of population health sciences at University of Utah Health and first author on the study. “Now, we’re seeing a growing body of evidence saying that that is not always the case. And oftentimes, shorter durations of antibiotics are as effective and safe as longer alternatives.”
The research team surveyed 1475 people across the country on their attitudes about antibiotic course length. They asked participants whether they’d feel more comfortable taking a three- to five-day course of antibiotics if they had pneumonia, as is recommended by current guidelines, or if they’d prefer an antibiotic course of a week or more, which is recommended by outdated guidelines. While shorter courses of antibiotics are as effective and safer for pneumonia than longer ones, about 60% of people said they’d rather take the longer course.
One of the main reasons people gave for preferring longer antibiotic courses was that they had been told to “always finish their antibiotic course” – 88% of respondents had heard of, and agreed with, this common mantra. Most had been told this by their clinician, and many had also heard it via a public health campaign.
A strong body of scientific evidence shows that, for many common infections, shorter courses of antibiotics work as well as longer courses and are less likely to cause side effects. Still, there are some cases, like tuberculosis, where longer courses are most effective.
The study authors suggest that doctors and public health campaigns use several evidence-informed strategies to better communicate the complex reality of antibiotic course length – for instance, avoiding overly simplistic claims that either shorter or longer courses are universally better, and acknowledging that as scientific evidence accumulates over time, health recommendations can change.
To patients who have been prescribed antibiotics, Thorpe recommends having an open conversation with your doctor about the appropriate course length and adherence plan to get health advice that’s specific to your situation.
“Discuss with your clinician what the right duration is for you and when the right time is to stop your course,” Thorpe says. “Getting advice directly from a clinician on a one-to-one basis about what is most appropriate for you in that situation is the right way to go.”
Thorpe emphasises that the changing recommendations are a positive outcome of increasing knowledge.
“Evidence is growing and guidance is evolving on antibiotic use, which is a normal process and a good sign that we are working to improve how we provide care,” he says. “Our knowledge about how best to use antibiotics has changed, but it has changed because we’re learning more, and it’s important that we make sure we are communicating this well to the public.”
Antimicrobial resistance in children is rising globally and will worsen over the next decade, threatening the effectiveness of life‑saving antibiotics, according to a world-first monitoring platform.
The findings, led by Murdoch Children’s Research Institute (MCRI) in collaboration with the University of Sydney, Clinton Health Access Initiative (CHAI) and The Chinese University of Hong Kong, analysed more than 106 000 infection samples from children, aged up to 18 years, across 82 countries, discovering that antibiotic resistance increased in every region between 2004 and 2022. Babies and children in intensive care and countries with fewer healthcare resources were the most affected.
Published in JAMA Pediatrics, the research found the increase is being driven largely by Gram-negative bacteria responsible for severe infections such as sepsis and pneumonia. Resistance rose most sharply to critical ‘Watch’ and ‘Reserve’ antibiotics, which the World Health Organization (WHO) classifies to limit overuse and help preserve their effectiveness when first-line treatments fail.
MCRI Associate Professor Penelope Bryant said the findings highlighted a widening gap between recommended antibiotic use and real‑world effectiveness, reinforcing the urgent need for improved surveillance, targeted antimicrobial stewardship and better access to effective antibiotics for children.
Forecasting future antimicrobial resistance
The newly launched AMR in Kids website, created by the study team, allows clinicians, researchers and policymakers to explore antibiotic resistance by country, bacteria and antibiotic class. It also provides region and pathogen-specific forecasts to 2035, helping researchers to identify emerging threats, inform treatment decisions and help guide public health planning.
MCRI and University of Sydney Dr Yanhong Jessika Hu said by combining almost two decades of global data with forecasting, the platform could identify where resistance was likely to emerge before it becomes an even greater clinical challenge.
Antimicrobial resistance occurs when bacteria evolve to withstand antibiotic treatment. As resistant bacteria emerge and spread through communities, infections become harder to treat. Children are especially vulnerable as they experience high rates of bacterial infections and have fewer antibiotic options than adults. In 2021, about 840,000 deaths in children under five years were associated with antimicrobial resistance.
“Antimicrobial resistance is one of the biggest threats to children’s health globally, but until now we haven’t had a clear picture of how it’s changing specifically in children,” Dr Hu said. “The AMR in Kids platform addresses a major gap by developing region and pathogen-specific forecasts for the next decade.”
Forecast modelling by the platform suggests that by 2035, some of the most dangerous pathogens could become highly resistant to last‑line treatments.
CHAI Senior Clinical Director Associate Professor Joseph Harwell said, “Better data is essential, but children can’t wait for perfect data. We need to use the best available evidence to guide action now.”
The research found two types of Gram-negative bacteria were driving antimicrobial resistance globally. Acinetobacter baumannii, which commonly causes hospital acquired bloodstream infections and pneumonia, showed the highest overall resistance. Klebsiella, causing urinary tract infections and liver abscesses, recorded the fastest increase, particularly in Southeast Asia, Eastern Europe and the Western Pacific. Alarmingly, resistance to last‑line carbapenem antibiotics is projected to rise substantially by 2035, reaching 82 per cent and 35 per cent, for each superbug, respectively.
Turning data into global action
Associate Professor Bryant said despite facing unique treatment challenges, children had been overlooked in global antibiotic resistance surveillance.
“Rising resistance to first- and now second-line drugs is the clinical reality for children,” she said. “Making antibiotic resistance in children visible, through AMR in Kids, is the first step towards changing its trajectory. By understanding where resistance is emerging and how it’s changing, we can better protect children now and preserve the effectiveness of antibiotics into the future.”
But Associate Professor Bryant said more action was needed on the global stage and measures specifically targeted towards children.
“In low-income countries we need to address unregulated antibiotic use and poor sanitation,” she said. “These countries need better access to diagnostic techniques and first-line antibiotics. Encouraging, Australia’s Department of Foreign Affairs and Trade has brought together experts including from the University of Melbourne and the WHO to develop solutions in the Western Pacific.
“In high-income countries, antibiotic overuse must be tackled across farming, veterinary, primary care and hospital settings, while infection control remains critical.
“We also need child-friendly antibiotic formulations, clearer dosing guidance and funding for trials on safely reducing antibiotic use. Consumers can help by talking with their GP about the risks of overprescribing antibiotics.”
A landmark international clinical trial, led in the UK by University College London researchers, has identified the optimal antibiotics for staph blood infection, a breakthrough that is set to reshape treatment for the life-threatening condition.
The SNAP trial found that a little used antibiotic, cefazolin, is as effective as and safer than the current UK standard therapy, flucloxacillin, for treating life-threatening staph blood infections. More than half of staph blood infections lead to sepsis and 15% to 25% of those who get these infections die within three months.
The researchers also found that a commonly used antibiotic, penicillin, can be used when the staph is treatable with this in the laboratory. And that similarly this is probably as effective as flucloxacillin, and safer.
The findings from the SNAP trial, published in the New England Journal of Medicine(NEJM) and The Lancet, challenge the long-held assumption that flucloxacillin should remain the default treatment and provide important new evidence to guide treatment strategy.
Staph (Staphylococcus aureus) is a leading cause of deadly blood infection, associated with over 1 million deaths worldwide each year. While effective antibiotic treatments exist, there has been no clear agreement about which antibiotic leads to the best outcomes for patients.
The NEJM results – Comparing cefazolin and flucloxacillin
In the trial published in the NEJM, researchers compared antibiotics used to treat meticillin-susceptible Staphylococcus aureus (MSSA) infections (i.e. blood infections that are not resistant to the meticillin antibiotic). It found cefazolin is at least as good as flucloxacillin for helping people to survive this infection, and associated with fewer side effects and a lower risk of kidney injury. It compared cefazolin and flucloxacillin in 1341 adults with staph blood infections across eight countries taking part in this part of the trial.
In patients who received cefazolin there were fewer cases of changes in how the kidneys are working (as measured by blood tests). Such kidney changes can cause long-term health problems and occurred in fewer of those given cefazolin compared to those given flucloxacillin.
The Lancet results – Comparing benzylpenicillin and flucloxacillin
In the paper published in The Lancet, the trial evaluated whether penicillin could be used to treat penicillin-susceptible Staphylococcus aureus (PSSA) infections where laboratory testing confirmed the susceptibility to penicillin.
This trial compared penicillin and flucloxacillin in 281 adults with staph blood infections. Penicillin was found to be likely to be at least as good for helping people to live with this infection as flucloxacillin.
In patients who received penicillin there were similarly fewer cases of changes in how the kidneys are working (as measured by blood tests). These occurred in 11% of those given penicillin compared to 22% of those given flucloxacillin. Mortality was also 14% in the penicillin group compared with 22% in the flucloxacillin group.
Professor Anna Goodman, UK lead of the SNAP trial at the UCL Innovative Clinical Trials, said: “This trial fills a major research gap. Our results strongly support cefazolin as the new first treatment for most adults with these infections. They also show a role for penicillin in some cases. It’s been helpful to deliver it in collaboration with researchers around the world and patients who have been affected by the condition, who we found via the UK Sepsis Trust.
“The results represent huge progress in the management of this disease with the first change in our approach to antibiotics in decades. Not only are cefazolin and penicillin as effective as flucloxacillin at treating penicillin- and meticillin-susceptible staph blood infection, but they also lead to significantly fewer abnormal blood tests.”
Staph infections are caused by bacteria called Staphylococcus aureus. They most often affect the skin and cause relatively minor problems. However, if the bacteria enter the bloodstream or other parts of the body, they can cause serious infections such as blood poisoning, blood infection or sepsis.
These more serious infections can affect anyone, but individuals at higher risk include people with catheters in their veins (as happens when people receive renal replacement therapy also called haemodialysis) or implanted devices (such as pacemakers), and people with diabetes. Those living with cancer and on immune suppressing medication, those who cannot get out of bed, and those who inject drugs are also more vulnerable to these infections.
The Royal Melbourne Hospital’s Professor Steven Tong, an infectious diseases physician at the Doherty Institute in Australia and global co-lead investigator of the SNAP Trial, said the results provide clear evidence that cefazolin should be considered the first-line option to treat MSSA blood infections.
“In the treatment of MSSA blood infections, there is an 89% probability that cefazolin is associated with lower mortality,” said Professor Tong.
“Patients treated with cefazolin fare better, with fewer deaths within 90 days (15% compared to 17% for those who received flucloxacillin). Cefazolin was also associated with fewer cases of acute kidney injury, at 14%, compared to 20% with flucloxacillin.
“The results are sufficiently compelling that I immediately made the switch in my own clinical practice.”
A shift away from flucloxacillin
Researchers said these results mark a turning point in the treatment of MSSA and PSSA blood infections, signalling a shift in clinical practice.
Penicillin was once widely used to treat Staphylococcus aureus, but antibiotic resistance of staph led clinicians to adopt flucloxacillin as the standard treatment for MSSA and PSSA blood infections. The findings support moving away from flucloxacillin as the default treatment for MSSA and PSSA blood infections, given safer alternatives are available.
The new results mark the first major finding from the ongoing SNAP trial, which aims to improve treatment for Staphylococcus aureus infections around the world. These parts of the trial took place in Australia, Canada, Israel, the Netherlands, New Zealand, Singapore, South Africa and the UK – each supported by regional funders working together to form one global network.
Global leadership was provided by the University of Melbourne trial team led by Professor Steven Tong and Professor Josh Davis.
So far, over 6000 participants have been enrolled in over 150 sites in those countries stated, and more recently in Germany and Sweden, Germany, Japan, Malaysia, and the United States. The trial will continue testing new approaches to improve outcomes for patients facing this serious infection.
Translating the findings
Researchers say the next challenge will be translating the findings into routine clinical practice.
While cefazolin availability may need to increase in some countries, researchers say implementation will ultimately depend on hospitals, laboratories and guideline groups incorporating the findings into clinical care.
Professor Goodman said: “Sepsis and staph blood infections are devastating for those affected and those who care for them. We are grateful to all those who took part and supported these two trials which will change practice. The platform trial continues as we ask further important questions in this area.”
A Monash University-led study has found that an unusual pairing of two commonly used antibiotics can kill and stop the spread of resistance in a highly drug-resistant bacterium, Pseudomonas aeruginosa, which can cause life-threatening bloodstream infections, pneumonia and meningitis.
Published in The Lancet Microbe,Monash Institute of Pharmaceutical Sciences (MIPS) researchers used a validated laboratory infection system in which they were able to expose bacterial samples from infected patients to simulated antibiotic dosing regimens, as would actually occur in hospitalised patients.
The discovery of the combination regimen of two so-called β-lactam antibiotics – the most commonly used antibiotics class against serious infections – comes in the context of the World Health Organization’s designation of Pseudomonas aeruginosa as a high-priority pathogen requiring rapid and sustained action.
Antimicrobial resistance (AMR) is one of the top global public health threats and was directly responsible for 1.14 million deaths in 2021. The impact of AMR puts many of the gains of modern medicine at risk, including jeopardising procedures and treatments such as surgery, caesarean sections and cancer chemotherapy.
AMR occurs when bacteria change over time and no longer respond to previously successful antibiotic treatments. Bacteria that develop AMR to several of the commonly used antibiotics can cause infections that are harder to treat, increasing the risk of disease spread, severe illness and death.
The development of new antibiotics has not kept pace with the rapid rise in AMR, which means some bacteria, such as Pseudomonas aeruginosa, have become resistant to essentially all available antibiotics.
Co-lead author, Associate Professor Cornelia Landersdorfer from MIPS, said their method was applied to the combination regimen of two β-lactam antibiotics, as well as treatments with each of the antibiotics alone. The combination regimen was very successful, as it resulted in much faster and generally substantially greater killing of bacteria than each antibiotic alone. In addition, the combination regimen very substantially suppressed resistance to both antibiotics.
Subsequently, a mathematical model, utilising quantitative systems pharmacology (QSP), was developed to describe the data from the infection system, and predict likely outcomes in patients. QSP models incorporate biological information, such as genetic information, to describe and predict how medicines work against disease in the human body.
“The QSP modelling approach coupled with genomic analysis performed in hospitals could represent a step towards optimising and personalising antibiotic regimens against life-threatening infections caused by Pseudomonas aeruginosa,” Associate Professor Landersdorfer said.
“This research is important because previous approaches to selecting an antibiotic regimen do not account for important pre-existing bacterial characteristics, including mutations, that can influence resistance emergence in bacterial patient isolates of important pathogens such as Pseudomonas aeruginosa.”
The QSP model in the current study is the first to incorporate information on the various resistance mechanisms present in bacterial samples from infected patients before treatment, and those which emerge during therapy with an antibiotic.
The developed QSP model describes the full time-course of bacterial growth, bacterial killing and emergent antibiotic resistance across multiple Pseudomonas aeruginosa strains isolated from patients. Importantly, the model also incorporates the contributions of various resistance mechanisms, including resistance mutations, to the emergent resistance.
The predictive potential of the novel QSP model developed in the study offers the future possibility of tailoring an antibiotic regimen to the specific resistance and other characteristics of the bacterial strain causing a serious infection in a patient.
First author, Dr Siobhonne Breen from MIPS said, “resistance of Pseudomonas aeruginosa emerges rapidly even to new antibiotics when used as a single therapy. Therefore, it is important to identify optimal antibiotic combination treatments that maximise killing of the bacteria and suppress the development of further resistance”.
Co-lead author Associate Professor Antonio Oliver from the Instituto de Investigación Sanitaria Illes Balears (IdISBa) and Hospital Son Espases, Palma de Mallorca, Spain said the research indicates that “by identifying resistance characteristics through rapid diagnostics, a therapy adapted to the individual pathogen and infected patient is an exciting future prospect”.
Resistance to antimicrobial agents is rising among human infections with Escherichia coli bacteria that produce the Shiga toxin, according to a study analysing data from nearly 2000 infections in the United States between 2010 and 2021.
The increase in resistance points to a need for antibiotic stewardship in the food production chain as well as in human health, says study leader Csaba Varga, a professor of pathobiology at the University of Illinois Urbana-Champaign.
“Shiga toxin–producing E. coli is a type of foodborne bacteria that can cause anything from mild diarrhoea to very serious illness. About 100 000 people in the U.S. get sick from this strain each year, and some end up in the hospital,” Varga said. “The biggest concern is for children under five years of age, who are more likely to develop serious complications, such as kidney failure.”
Varga and graduate student Tarjani Bhatt used data reported by the U.S. Centers for Disease Control and Prevention, which collects the information through a national surveillance system. They focused on the E. coli strain O157, which produces the Shiga toxin responsible for the majority of severe illnesses. They looked at 1995 samples collected between 2010 and 2021 to see whether there was any change in antimicrobial resistance rates over time, and whether there were any patterns in age or geography.
“Most of the previous studies have looked at snapshots in time, not how resistance changes year by year. We didn’t have a clear picture of long-term trends, whether resistance was increasing, decreasing or staying the same,” Varga said. “Resistance doesn’t stay in one place; it moves through people, animals and the environment. Our study helps fill those gaps by looking at when, where and in whom resistance is emerging over time.”
The group found that, while overall resistance remains low, it has steadily increased over time – especially for the common antibiotics tetracycline and sulfisoxazole. They also found that resistance varied by geographical region and by age group, with younger adults in their 20s and 30s most likely to have infections resistant to some antibiotics.
The most mystifying aspect of the findings is that antibiotics are not typically recommended for Shiga-producing E. coli infections, Varga said. Though the treatment kills the bacteria, that action triggers the release of more Shiga toxin, making the illness more dangerous and increasing the risk for serious complications. Antibiotics are avoided unless the patient has another severe infection at the same time.
“Even though we don’t usually treat this infection with antibiotics, we’re still seeing resistance emerging and spreading, which tells us these bacteria are being exposed to antibiotics somewhere along the way,” Varga said.
The researchers propose a “One Health” approach to the issue, taking into account not only human health and antibiotic use, but animals and environment as well, particularly because the illness is foodborne.
“Better antibiotic stewardship in agriculture, along with food safety and environmental controls, will be key to slowing this trend. What happens on farms, in food production and in the environment can directly impact human health. Prevention has to happen from farm to fork,” Varga said.
Drug-resistant Salmonella. Credit: CDC on Unsplash
Researchers at McMaster University have discovered a new antibiotic that kills some of the world’s most dangerous and drug-resistant bacteria – and does so by targeting a previously unknown vulnerability, opening the door to an entirely new class of treatments.
The new compound, called manikomycin, was identified by a team led by McMaster Professor Gerry Wright and has shown early effectiveness against priority pathogens including Salmonella, E. coli and Klebsiella.
Unlike any antibiotic currently used in clinics, it works by blocking the exit site of the ribosome, the protein-producing machinery found inside every bacterial cell.
The discovery, published today in Nature, marks the fourth new antibiotic candidate from Wright’s lab in just over a year, underscoring a promising new approach to drug discovery at a time when antibiotic resistance is a growing global threat.
“So we’ve not only found a brand-new drug candidate, but we’ve also established a brand-new target in bacteria that could potentially be exploited with other new drugs.”
It’s the latter part of the discovery that has researchers most excited. Wright notes that because most antibiotics in use today target the same handful of vulnerabilities on the ribosome, bacteria have evolved broad defence strategies against such attacks. However, drugs that attack a different part of the ribosome – the exit site – leave them defenceless.
“Even newly discovered drugs that attack those same old targets may quickly face resistance,” says Wright, a professor in McMaster’s Department of Biochemistry and Biomedical Sciences.
“But across the history of medicine, we’ve put absolutely no selective pressure on this particular target, so bacteria have no existing resistance mechanisms for manikomycin.”
Wright likens the ribosome to a factory assembly line. Finished components, he says, must be moved off the line before the next piece can advance. Manikomycin blocks the exit lane, causing the entire assembly process to jam and eventually grind to a halt. And, without the ability to produce proteins, bacteria cannot survive.
The discovery of manikomycin builds on work that began more than 75 years ago, when scientists first discovered that the soil bacterium Streptomyces rimosus produced oxytetracycline, a powerful new drug that would help usher medicine into the antibiotic age.
While the breakthrough was one of several like discoveries made in the mid-1900s, S. rimosus and related bacteria have long since been abandoned as a potential source of new antibiotics.
“There is an overwhelming perception in science that these bacteria have been mined completely dry – that we’ve found all there is to find,” Wright says. “Our lab has found that this is not at all the case.”
Wright’s group, working with collaborators at the University of Illinois Chicago and the University of Hamburg in Germany, used an advanced laboratory technique called fractionation to uncover the new antibiotic.
By filtering out oxytetracycline and other abundant compounds from the chemical mixtures produced by S. rimosus, the researchers were able to isolate scarcer molecules that had gone unnoticed over the years.
Manpreet Kaur, a postdoctoral fellow in Wright’s lab and first author on the new study, says that finding a viable new drug candidate this way signals new opportunities for antibiotic discovery.
“There is likely so much still to be discovered through fractionation,” says Kaur. “Revisiting the extracts of even-well studied bacteria like Streptomyces may lead to similar discoveries in the future.”
Wright’s team is now advancing manikomycin toward clinical development. They have already shown that the new antibiotic is not toxic to human cells, and that it works well in a lab-controlled model of infection – both key milestones on the early development pathway.
They are now working on optimiaing the drug’s “residency time” – or how long it stays active in the body – and have produced 60 derivatives, with plans to push the best one forward.
“We’re excited about this molecule’s potential,” Wright says. “There’s a clear path forward, and we may even be able to expand its spectrum so that it eventually affects even more bacteria, too.”
Before antibiotics and antiseptics, healers across ancient Egypt, Greece, and China reached for honey to treat wounds. Archaeological evidence shows humans have been harvesting and collecting honey for thousands of years – and for much of that time, we understood it to be more than just food.
Today, honey sits in most kitchen cupboards as a perfectly ordinary pantry staple. But honey has never entirely shed its medicinal reputation. And modern research shows us why: it possesses genuine antimicrobial properties, capable of killing or inhibiting a wide range of bacteria, including drug-resistant strains.
This matters now more than ever. Antimicrobial resistance – where bacteria evolve to survive drugs designed to kill them – is one of the defining public health crises of our time. Infections caused by these resistant microbes are becoming harder and more expensive to treat, creating an urgent need for alternative therapies.
Our new study, published in the journal MicrobiologyOpen, shows honeys from Australia’s native flora might be a big part of the solution.
What did we do?
We analysed 56 honey samples collected from more than 35 apiaries across New South Wales. Many samples came from landscapes recovering from the 2019–2020 bushfires. Most were derived from native Australian plants such as eucalyptus, leptospermum and melaleuca.
We tested the honeys against two common bacterial pathogens: Staphylococcus aureus (golden staph) and E. coli – both among the six leading causes of deaths associated with antibiotic resistance. For each sample we measured the minimum concentration needed to stop bacterial growth. The lower the concentration, the more potent the honey.
We also carried out comprehensive chemical profiling, measuring sugars, organic acids, amino acids, enzymes and a wide range of plant-derived compounds. Statistical and machine-learning analyses helped us identify which chemical features best explained antibacterial strength.
What did we find?
More than three-quarters of the honey samples stopped bacterial growth even when the honeys were diluted to 10% or less. This places Australian native flora honeys alongside some of the world’s most potent varieties.
The most striking factor was floral diversity.
Honeys from mixed floral sources – where bees foraged across multiple native plant species rather than a single species – were consistently the most antimicrobial.
This potency wasn’t due to any single compound but to a chemically rich combination.
Multiple bioactive factors – substances that have a measurable effect on living cells or tissues – worked together to inhibit bacteria. These included naturally produced hydrogen peroxide, plant-derived phenolic compounds (naturally occurring chemicals that plants produce as part of their own defence systems), and antioxidants.
When bacteria encounter honey, this combination acts on several fronts at once. The low moisture content draws water out of bacterial cells, while the acidity disrupts their metabolism. Hydrogen peroxide damages their cellular structures, and phenolic and antioxidant compounds interfere with their ability to function and reproduce.
The strength of mixed floral honeys may also reflect the health of the bees themselves.
Access to diverse forage keeps colonies well nourished. And healthier bees produce more biologically active honey as their enzymes help integrate and activate the plant compounds into a complex antimicrobial mixture.
What does this mean for antimicrobial resistance?
Honey won’t replace antibiotics for serious or systemic infections.
But for topical applications – chronic wounds, burns, or surgical site infections – it is a genuinely promising option. Because honey attacks bacteria through multiple simultaneous mechanisms, resistance is far less likely to emerge than with single-target drugs. Our team is now exploring these applications in more detail.
Australia is particularly well-placed to lead in bioactive honey production. Around 70% of Australian honey comes from native plants. These plants are found not only in forests but also across farmland, regional landscapes, and urban green spaces.
Our findings show that prioritising floral diversity over monoculture isn’t just good for ecosystems – it produces more potent honey. With the beekeeping industry under serious pressure from bushfires, floods, and now the varroa mite, protecting and restoring florally-rich landscapes is critical: for bee health, for industry resilience, and for expanding our natural antimicrobial toolkit.
In the meantime, the next jar of Australian honey you buy may just be doing more good than you realise.
The new device sprays mist to treat deep wound infections without causing kidney damage
Hongmin Sun demonstrating the new device.
A University of Missouri researcher has unveiled a safer, smarter way to fight drug-resistant infections. Hongmin Sun, an associate professor in the School of Medicine, demonstrated that a spray-mist device can deliver last-resort antibiotics directly into infected tissue without the harmful side effects often caused by delivery via the bloodstream.
In a recent study, researchers worked with an industry partner to use a needle-free device to treat methicillin-resistant Staphylococcus aureus (MRSA), a dangerous bacterium that has become resistant to many common antibiotics.
The device successfully delivered the common last-resort antibiotic vancomycin deep into infected tissue without typical side effects such as kidney damage. Unlike topical creams or ointments that are easily wiped away or bloodstream delivery that risks organ damage, the spray-mist technology pushed the medicine through the skin to successfully treat the infection.
Sun collaborated with former Mizzou researcher Lakshmi Pulakat, now a professor of medicine at Tufts University, and Droplette Inc. to use the patented device for antibiotic delivery. The findings pave the way for future clinical trials as researchers seek FDA approval.
The team is hopeful the spray-mist device might one day be used in wound care in challenging settings.
“Whether it’s people with diabetic foot ulcers or soldiers hurt in battle, we wanted to come up with a new approach to treat these severely infected wounds in a more targeted way,” Sun said. “This can be a game-changing therapy for treating those with severely infected wounds.”
Pulakat said the technology is an example of compassionate care.
“This method of delivering last-resort antibiotics could prevent countless amputations and help save lives,” she said. “Dr. Sun is an internationally recognized expert in the field of pathogenic microbiology, and our collaboration with an industry partner has helped make this translational research possible.”
A commonly prescribed antibiotic could help reduce the risk of some young people developing schizophrenia, new research suggests. Experts found that patients of adolescent mental health services who were treated with the antibiotic doxycycline were significantly less likely to go on to develop schizophrenia in adulthood compared with patients treated with other antibiotics.
The researchers say that the findings highlight the potential to repurpose an existing, widely used medication as a preventive intervention for severe mental illness.
Lower risk
Schizophrenia is a severe mental disorder that typically emerges in early adulthood and is often associated with hallucinations and delusional beliefs.
To better understand potential ways of preventing the condition, researchers from the University of Edinburgh, in collaboration with the University of Oulu and University College Dublin, applied advanced statistical modelling to large-scale healthcare register data from Finland.
The team analysed data from more than 56 000 adolescents attending mental health services who had been prescribed antibiotics. They found that those treated with doxycycline had a 30–35% lower risk of developing schizophrenia than peers who received other antibiotics.
The researchers hypothesised that the protective effect could be linked to doxycycline’s impact on inflammation and brain development.
Reduce inflammation
Doxycycline is a broad-spectrum antibiotic commonly used to treat infections and acne. Previous studies suggest it can reduce inflammation in brain cells and influence synaptic pruning – a natural process where the brain refines its neural connections. Excessive pruning has been associated with the development of schizophrenia.
Further analyses showed that the lower risk wasn’t simply because the young people may have been treated for acne rather than having infections, and was unlikely to be explained by other hidden differences between the groups.
The study is published in the American Journal of Psychiatry. It involved researchers from the University of Edinburgh, the University of Oulu, University College Dublin, and St John of God Hospitaller Services Group, and was funded by the Health Research Board.
As many as half of the people who develop schizophrenia had previously attended child and adolescent mental health services for other mental health problems. At present, though, we don’t have any interventions that are known to reduce the risk of going on to develop schizophrenia in these young people. That makes these findings exciting.
Because the study was observational in nature and not a randomised controlled trial, it means we can’t draw firm conclusions on causality, but this is an important signal to further investigate the protective effect of doxycycline and other anti-inflammatory treatments in adolescent psychiatry patients as a way to potentially reduce the risk of developing severe mental illness in adulthood.
Professor Ian Kelleher, Professor of Child and Adolescent Psychiatry at the University of Edinburgh
In Pakistan, 50% of strains of a common milk bacterium, Staphylococcus epidermidis, were multi-drug resistant
Cultured Staphylococcus epidermidis isolates from raw milk samples on MSA. Image credit: Inamullah and colleagues, Abdul Wali Khan University Mardan, Pakistan, CC-BY 4.0
Raw cow and sheep milk is frequently contaminated with antibiotic-resistant bacteria that could pose a threat to human and animal health, reports a new study led by Tahir Usman of Abdul Wali Khan University Mardan, Pakistan, published November 12, 2025 in the open-access journal PLOS One.
In Pakistan, over 95% of milk is consumed in its raw form, which has not been pasteurized to kill off harmful bacteria. Milk can become contaminated by bacteria through improper handing or from infections in the teat, called subclinical mastitis. The overuse of antibiotics to treat subclinical sumastitis has led to the emergence of multidrug-resistant bacterial strains, which could then be transmitted to humans through raw milk.
In the new study, researchers investigated the risk posed by Staphylococcus epidermidis, a subclinical mastitis-causing bacteria that often does not lead to visible symptoms in the cow, but results in contaminated, lower-quality milk. They collected 310 milk samples, about half from cattle and half from ewes, and tested them for subclinical mastitis. They also isolated strains of Staphylococcus epidermidis from the milk samples and screened them for antibiotic resistance. About one quarter of the samples showed evidence of subclinical mastitis and almost 13% (1 in 8) were contaminated with Staphylococcus epidermidis. Strikingly, 95% of Staphylococcus epidermidis bacteria isolated from the milk were resistant to penicillin and erythromycin, and half were resistant to three or more antibiotics.
In humans, Staphylococcus epidermidis is a common, generally harmless inhabitant of the skin, but the researchers point out that multi-drug resistant Staphylococcus epidermis bacteria in raw milk could spread antimicrobial resistance to more harmful pathogens, like Staphylococcus aureus, the MRSA pathogen.
The study’s findings underscore the high rates of subclinical mastitis in cattle and ewes, and indicate that Staphylococcus epidermidis might be an important pathogen impacting both animal health and food safety. The high rates of antibiotic resistance observed in the samples also emphasize the urgent need for improved antibiotic stewardship in agriculture to prevent the rise of multi-drug resistant strains.
The authors add: “The presence of multidrug-resistant Staphylococcus epidermidis in raw milk highlights how on-farm antibiotic use directly shapes public health risks. These findings emphasize the urgent need for responsible antibiotic use and improved hygiene practices in the dairy sector to reduce the risk of antimicrobial resistance transmission through the food chain.”
