Publications by authors named "T Peel"

Large, randomised trials are the bedrock of evidence-based medicine, but the resources required to complete such trials greatly limit the number of important clinical questions that can be addressed within a reasonable period of time. Adaptive platform trials can identify effective, ineffective, or harmful treatments faster. These trials have been shown to deliver rapid evidence through the COVID-19 pandemic and are now being adopted across surgery and anaesthesia, with many opportunities for surgeons, anaesthetists, and other perioperative physicians to conduct and collaborate in platform trials.

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Large, randomized trials are the bedrock of evidence-based medicine, but the resources required to complete such trials greatly limit the number of important clinical questions that can be addressed within a reasonable period of time. Adaptive platform trials can identify effective, ineffective, or harmful treatments faster. These trials have been shown to deliver rapid evidence through the COVID-19 pandemic and are now being adopted across surgery and anaesthesia, with many opportunities for surgeons, anaesthetists, and other perioperative physicians to conduct and collaborate in platform trials.

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Introduction: Diabetic foot osteomyelitis (DFO) is a significant complication of diabetic foot disease; however, diagnosis remains challenging and treatment success is difficult to ascertain. Literature in this space that has utilized varying diagnostic criteria and ideal outcome measures for success is unclear.

Areas Covered: This scoping review assesses methods of diagnosis of DFO and definitions of treatment outcomes in the literature assessing antibiotic therapy for treatment of DFO.

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Background: Healthcare-associated infections (HAI) and antimicrobial use (AMU) are drivers for antimicrobial resistance, and robust data are required to inform interventions and track changes. We aimed to estimate the prevalence of HAI and AMU at Port Moresby General Hospital (PMGH), the largest hospital in Papua New Guinea.

Methods: We did a point prevalence survey (PPS) on HAI and AMU at PMGH in May 2023 using the European Centre for Disease Prevention and Control (ECDC) PPS protocol.

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Article Synopsis
  • Critically ill patients often receive insufficient beta-lactam antibiotic doses due to physiological changes, which can lead to treatment failures or harmful side effects.
  • The study aims to evaluate the feasibility and effectiveness of implementing therapeutic drug monitoring (TDM) for beta-lactam dosing in an intensive care setting, comparing TDM-guided dosing with standard care.
  • The trial will assess recruitment feasibility, TDM fidelity, and monitor secondary outcomes like achieving dosing targets and the occurrence of drug-related toxicities.
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