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Introduction One of the main tools to optimise antibiotics use is education of prescribers. The aim of this article is to study undergraduate education in the field of infectious diseases, antimicrobial resistance and antibiotic stewardship from the perspective of Spanish medical students. Material and methods An anonymous online questionnaire was distributed among sixth grade students using different channels in Europe, within the ESGAP Student-Prepare survey. The questionnaire included 45 questions about knowledge, attitudes and perceptions about diagnosis, bacterial resistance, use of antibiotics and undergraduate training in infectious diseases. We present here the Spanish results. Results A total of 441 surveys were received from 21 medical schools. A total of 374 responses (84.8%) were obtained from the 8 most represented faculties, with a response rate of 28.9%. Most students felt adequately prepared to identify clinical signs of infection (418; 94.8%) and to accurately interpret laboratory tests (382; 86.6%). A total of 178 (40.4%) acknowledged being able to choose an antibiotic with confidence without consulting books or guidelines. Only 107 (24.3%) students considered that they had received sufficient training in judicious use of antibiotics. Regarding learning methods, the discussion of clinical cases, infectious disease unit rotatories and small group workshops were considered the most useful, being evaluated favourably in 76.9%, 76% and 68.8% of the cases. Conclusion Medical students feel more confident in the diagnosis of infectious diseases than in antibiotic treatment. They also feel the need to receive more training in antibiotics and judicious antibiotic use.

Objectives We had for aim to learn about medical students’ knowledge and perspectives on antibiotic prescribing and bacterial resistance. Methods Penultimate and final year students at a French medical school were invited to participate in an anonymous online survey in summer 2012. Results The response rate was 20% (60/297). Penultimate and final year students gave similar answers. Students felt more confident in diagnosing an infection, and less confident in choosing the correct dose and interval of antibiotic administration. Seventy-nine percent of students wanted more training on antibiotic treatments. Sixty-nine percent of students knew that antibiotic prescriptions were inappropriate or unnecessary in 21–60% of the cases, and 95% believed that these prescriptions were unethical. Only 27% knew that more than 80% of antibiotic prescriptions were made in community practice. Students believed that the most important causes of resistance were that too many prescriptions were made and broad-spectrum antibiotic use; 27% believed poor hand hygiene was “not at all important”. Ninety-four percent believed resistance was a national problem, and 69% mentioned it as a problem in their hospital. Sixty-three percent thought that the antibiotics they would prescribe would contribute to resistance, and 96% thought resistance would be a greater problem in the future. Twenty-two percent knew MRSA bacteremia rates had decreased over the past decade in France. Conclusions Medical students are aware that antibiotic resistance is a current and growing problem. They would like more training on antibiotic selection.

Objective: A major site of action for the atheroprotective drug nicotinic acid (NA) is adipose tissue, via the G-protein-coupled receptor, GPR109A. Since, adipose tissue is an active secretory organ that contributes both positively and negatively to systemic inflammatory processes associated with cardiovascular disease, we hypothesized that NA would act directly upon adipocytes to alter the expression of pro-inflammatory chemokines, and the anti-inflammatory adipokine adiponectin. Methods and results: TNF-α treatment (1.0 ng/mL) of 3T3-L1 adipocytes resulted in an increase in gene expression of fractalkine (9 ± 3.3-fold, P < 0.01); monocyte chemoattractant protein-1 (MCP-1) (24 ± 1.2-fold, P < 0.001), 'regulated upon activation, normal T cell expressed and secreted' (RANTES) (500 ± 55-fold, P < 0.001) and inducible nitric oxide synthase (iNOS) (200 ± 70-fold, P < 0.05). The addition of NA (10-4 M) to TNF-α-treated adipocytes attenuated expression of fractalkine (50 ± 12%, P < 0.01); MCP-1 (50 ± 6%, P < 0.01), RANTES (70 ± 3%, P < 0.01) and iNOS (60 ± 16%). This pattern was mirrored in protein released from the adipocytes into the surrounding media. The effect on gene expression was neutralised by pre-treatment with pertussis toxin. NA attenuated macrophage chemotaxis (by 27 ± 3.5%, P < 0.001) towards adipocyte conditioned media. By contrast, NA, (10-6-10-3 M) increased, in a dose-dependent manner, mRNA of the atheroprotective hormone adiponectin (3-5-fold n = 6, P < 0.01). Conclusions: NA suppresses pro-atherogenic chemokines and upregulates the atheroprotective adiponectin through a G-protein-coupled pathway. Since adipose tissue has the potential to contribute to both systemic and local (perivascular) inflammation associated with atherosclerosis our results suggest a new "pleiotropic" role for NA. © 2009 Elsevier Ireland Ltd. All rights reserved.

Introduction Reduire les durees d’antibiotherapie limite l’emergence des resistances bacteriennes. Les pratiques actuelles concernant les durees des antibiotherapies sont cependant mal connues. Materiels et methodes Cette enquete internationale ESCMID-SPILF, ouverte du 1 er septembre au 1 er decembre 2016, avait pour but d’evaluer les durees d’antibiotherapie conseillees par les medecins/pharmaciens seniors donnant des avis au minimum hebdomadaires en antibiotherapie. Nous avons evalue leurs pratiques a l’aide de quinze vignettes presentant des situations cliniques d’evolution favorable frequemment rencontrees en pratique courante. Les participants ont ensuite ete interroges sur la duree minimale de traitement qu’ils seraient prets a prescrire dans les memes situations. Resultats Huit cent soixante-six professionnels (infectiologues 59 % et microbiologistes 23 %) provenant de 58 pays (France 19 %, Royaume-Uni 16 %, Espagne 9 % et Allemagne 8 %) ont participe. La duree de prescription conseillee par les participants excedait parfois la duree minimale validee dans la litterature : 8 jours conseilles versus 7 jours valides dans la litterature pour un erysipele, 7 vs 5 jours pour une exacerbation de BPCO, ou 7 vs 5 jours pour une cholecystite aigue non compliquee et operee dans les 24 heures. Les durees conseillees etaient cependant majoritairement (10/15 vignettes) en accord avec la litterature. Les participants declaraient etre prets a raccourcir les durees conseillees dans 8/15 vignettes, avec par exemple 28 jours de traitement pour une infection de pied diabetique, 5 jours pour une exacerbation de BPCO ou 10 jours pour une bacteriemie a S . aureus non compliquee. Conclusion Les professionnels ayant une activite de conseil en antibiotherapie declarent recommander des durees plutot courtes d’antibiotherapie, et semblent meme enclins a raccourcir encore ces durees. L’application des futures propositions de la SPILF sur le sujet semble donc possible en pratique.