Dr Brecht Ingelbeen and Dr Daniel Valia join Senior Editor Phoebe Hall to discuss a new trial in the journal (the CABU-EICO trial) testing a co-created behavioural intervention bundle to improve antibiotic use, patient management, and water, sanitation and hygiene in rural communities in Burkina Faso and DR Congo. They explain why the study focused on community prescribing (not hospitals), the primary endpoint was a reduction in WHO AWaRE Watch antibiotics (not overall antibiotics), and the intervention targeted all providers of antibiotics in the community, including informal vendors.

Finally, they discuss the importance of designing an intervention bundle that was truly tailored to local context yet practical, sustainable, and scalable beyond the study sites. A parallel study reporting the effect of the intervention bundle on ESBL-producing Escherichia coli colonisation (a co-primary outcome of the trial) is in press at The Lancet Microbe.

To read the full article:

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00169-6/fulltext

The Lancet Infectious Diseases in conversation with... is part of the Lancet Group podcast offering.

Editorial team: editor-in-chief Ursula Hofer, deputy editor Marco De Ambrogi, and senior editors Syeda Saleha Hassan and Phoebe Hall

Podcast editing: Matteo Simonetti

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