Page 55 - Rappaport Institute Magazine 2024

THE RAPPAPORT INSTITUTE
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Fighting multidrug-resistant bacteria in hospitals
I am a clinician heading The Infectious Diseases division at Rambam Health Care Campus. My research focuses on antibiotic stewardship, multidrug-resistant bacteria, antibiotic treatment
of severe infections, revival of old antibiotics, hospital-acquired infections and generating evidence-based medicine for clinical questions. My research is clinical investigator-initiated and patient- oriented. I collaborate closely with colleagues in Europe, the
US, Canada, Australia and Singapore. Early on in my career I participated in the developing of a decision support system for antibiotic treatment and led a randomized controlled trial and other studies evaluating the efficacy of the decision support system. In randomized controlled trials, I evaluated the appropriate duration of treatment for bloodstream infections, compared antibiotics for the treatment of carbapenem-resistant Gram-negative infections and MRSA. In other studies, I assessed the effectiveness of appropriate empirical antibiotic treatment and determinants affecting the rates of appropriate empirical antibiotic treatment. My methodological expertise concerns study design, risk of bias assessment, meta- analysis and evidence grading. I am an editor with Clinical Microbiology and Infection and the Cochrane Infectious Diseases Group and a methodologist supporting WHO and ESCMID guidelines development.
Selected Publications
ˆ Paul M, Daikos GL, Durante-Mangoni E, Yahav D, Carmeli Y, Benattar YD, Skiada A, Andini R, Eliakim-Raz N, Nutman A, Zusman O, Antoniadou A, Pafundi PC, Adler A, Dickstein Y, Pavleas I, Zampino R, Daitch V, Bitterman R, Zayyad H, Koppel F, Levi I, Babich T, Friberg LE, Mouton JW, Theuretzbacher U, Leibovici L. Colistin alone versus colistin plus meropenem for treatment of severe infections caused by carbapenem-resistant Gram-negative bacteria: an open-label, randomized controlled trial. Lancet Infect Dis. 2018 Apr;18(4):391-400.
ˆ Yahav D, Franceschini E, Koppel F, Turjeman A, Babich T, Bitterman R, Neuberger A, Ghanem-Zoubi N, Santoro A, Eliakim-Raz N, Pertzov B, Steinmetz
T, Stern A, Dickstein Y, Maroun E, Zayyad H, Bishara J, Alon D, Edel Y, Goldberg E, Venturelli C, Mussini C, Leibovici L, Paul M, for the Bacteremia Duration Study Group. Seven versus fourteen Days of Antibiotic Therapy for uncomplicated Gram- negative Bacteremia: a Non-inferiority Randomized Controlled Trial. Clin Infect Dis. 2019;69(7):1091-1098. (Editor’s choice + Editorial)
ˆ Varon B, Palacios-Baena ZR, de Kraker MEA, Rodríguez-Baño J, Leibovici L, Paul M; UNIFORM research group. Universal Risk Factors for Mortality in Bloodstream Infections (UNIFORM): a systematic review and Delphi survey. Clin Microbiol Infect. 2024 Jan 3:S1198-743X(24)00004-1. doi: 10.1016/j.cmi.2023.12.030. Epub ahead of print. PMID: 38182050.
Grants and Awards
ˆ 5th and 6th frameworks, IMI, JPIAMR, Horizon 2020 and ERA PerMed
ˆ Office of the Chief Scientist, Ministry of Science, Technology and Space, The Israel National Institute For Health Policy Research, Michigan-Israel Partnership for Research and Education, ISF.
Paul@rambam.health.gov.il
Mical Paul Lab
Mical Paul, MD
Professor of Medicine (Infectious diseases)
MD, 1996 – The Hebrew University of Jerusalem, Israel
Universal risk factors for mortality in bloodstream infections depicted using a Direct Acyclic Graph. Studies evaluating the management of sepsis frequently need to assess risk factors for mortality. Through a systematic review and a Delphi survey we developed a consensus on the variables needed for mortality risk prediction in all studies. These constitute the minimal set of variables required in all studies evaluating mortality following sepsis. Varon et al. Clin Microbiol Infect 2024 Jan 3:S1198-743X(24)00004-1. doi: 10.1016/j.cmi.2023.12.030.