Reply to Solnick
Clinical Infectious Diseases®
0 Department of Medicine, St John Hospital and Medical Center , Grosse Pointe Woods, Michigan
1 David Geffen School of Medicine, University of California , Los Angeles
2 R. M. Alden Research Laboratory , Santa Monica
TO THE EDITOR—The letter by Dr Solnick
about his concerns of potential bias and/
or conflicts of interest by the authors of 2
recent reviews in Clinical Infectious
Diseases raises important issues [1–3]. The
journal and its editors recognize the need
to provide our readers with updated
information about new and evolving
antimicrobial agents, written by acknowledged
experts in the particular area. Such
experts must have requisite experience and
background to provide scientific
information as well as clinical guidance. In the
course of development of such drugs,
pharmaceutical companies utilize such
experts for guidance and clinical studies
as well. Therefore, it is almost inevitable
that these experts are called upon by CID
as well as industry. To exclude such
experts from providing expert opinion to
the readership of CID invokes an a priori
assumption that having research grants
or contacts with industry fosters innate
bias, which is in itself a form of bias and
unfounded use of the doctrine of political
correctness. CID and its editors are
cognizant of these potential issues and,
therefore, all submitted manuscripts undergo
a rigorous peer review process. All
authors must submit disclosure of conflicts
of interest, which is an international
standard. Every article submitted for
consideration to the sections of CID referred to
in Dr Solnick’s letter were assigned to the
special section editor and reviewed by at
least 2 external peer reviewers, who are
content experts on the subject matter of
the submitted manuscript. The reviewers
rate the articles for importance and
scientific validity and screen for any bias or
inaccuracy that must be addressed by the
authors prior to reaching any decision
about publication. Subsequently, the
revised manuscript and a recommendation
are submitted to the Editor-in-Chief of
CID, who makes the final decision.
Although invited as reviews, not all articles
are accepted. Once published, an open
process proceeds whereby scientists and
experts are encouraged to comment about
scientific issues and perceived biases in a
Letter to the Editor, as done, for example,
by Eschenauer et al  and the
subsequent response by the authors .
All humans have preferences and
biases, but this does not necessarily cloud
one’s judgment or scientific integrity. It
is correct that the manuscripts under
consideration had support from industry,
and the authors disclosed financial
relationships or employment from the
manufacturers. We agree with Dr Solnick that
critical readers will draw their own
conclusions about the manuscripts with
these disclosures under consideration.
However, we cannot accept the
categorical presumption that because a specific
individual or a research study is funded
by industry that there is innate bias in
the results and is tainted with medical
misconduct. It reminds us of the Lyme
disease guidelines  suit brought by
the State of Connecticut that resulted in
an outcome that the guidelines were
correct, in which the only finding was that
the experts had done research on Lyme
disease sponsored by industry or grants.
We would remind the readers that the
significant progress being made toward the
Infectious Diseases Society of America’s
10 × 20 Initiative in new antimicrobial
agent development would not be possible
without the support of industry.
Furthermore, having reviewed studies going into
approval of a new agent by the US Food
and Drug Administration requires a
heightened level of scrutiny and statistical
rigor that continues to tax and challenge
the pharmaceutical industry.
The specific issue of optimal therapy
for methicillin-resistant Staphylococcus
aureus infections continues to be a
difficult and challenging issue for clinicians.
Stifling progress in this clinical area will
limit therapeutic options. Disseminating
information and engendering discussion
on new advances and appropriate
alternate considerations reflects the progress
being made in this area. CID continues to
remain the premier journal that infectious
disease clinicians refer to in assisting them
in their clinical practice. Providing them
with information on the use of a new drug
in bacteremia and the evidence available
in this area is an invaluable resource that
should be encouraged, not limited. As
always, there must be fairness and balance
between sharing clinical information while
avoiding unwarranted promotion. The
special section editors will continue to
accept this challenge and select authors who
are the most knowledgeable, while assuring
a fair comment on positioning of drugs.
Potential conflict of interest. L. D. S. has
received institutional grants and honoraria from
Theravance. E. J. C. G. reports no potential
conflicts of interest.
Both authors have submitted the ICMJE Form
for Disclosure of Potential Conflicts of Interest.
Conflicts that the editors consider relevant to the
content of the manuscript have been disclosed.
Ellie J. C. Goldstein1,2 and Louis D. Saravolatz3
1. Solnick JV . Invited review articles: do they inform or do they advertise? Clin Infect Dis 2015 ; 61 : 484 .
2. Kullar R , McKinnell JA , Sakoulas G . Avoiding the perfect storm: the biologic and clinical case for reevaluating the 7-day expectation for methicillin-resistant Staphylococcus aureus bacteremia before switching therapy . Clin Infect Dis 2014 ; 59 : 1455 - 61 .
3. Corey GR , Rubinstein E , Stryjewski ME , Bassetti M , Barriere SL . Potential role for telavancin in bacteremic infections due to gram-positive pathogens: focus on Staphylococcus aureus . Clin Infect Dis 2015 ; 60 : 787 - 96 .
4. Eschenauer GA , Nagel JL , Kubin CJ , Lam SW , Patel TS , Potoski BA . Calming the “perfect storm” in methicillin-resistant Staphylococcus aureus bacteremia: a call for a more balanced discussion . Clin Infect Dis 2015 ; 60 : 670 - 1 .
5. Kullar R , McKinnell JA , Sakoulas G . Reply to Eschenauer et al. Clin Infect Dis 2015 ; 60 : 671 - 2 .
6. Wormser GP , Dattwyler RJ , Shapiro ED . The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice