The White House is seeking greater control over $48 billion in federal research funding, in an apparent effort to further President Donald Trump's political agenda, according to recent reporting from the Washington Post, New York Times, and Politico.

The president has reportedly ordered Russell Vought, director of the Office of Management and Budget, to draft an executive order that would require grant applications to the National Institutes of Health (NIH) to be reviewed by a board of political appointees. 

The Times reports that Trump's goal is to promote conservative ideology and cultural change through directing scientific research at the nation's more prestigious universities, which the president has frequently sparred with during his second term. 

The effort has drawn rebuke from those concerned with academic freedom, including the advocacy organization Stand Up for Science, which warns that this rule threatens to undermine decades of peer-reviewed research.

"These actions show us an administration determined to take control of our science," Stand Up for Science CEO Colette Delawalla, PhD, said in a statement.

Vought keeps coming after NIH oversight

Shifting decision power over federal research funding has been an ongoing project of Vought's. In May, his office proposed a rule that would require "senior appointees," selected by politically appointed agency heads, to review NIH research proposals. 

The proposed rule states that this change would enhance accountability, encourage agencies to broaden the range of recipients, and ensure that "discretionary awards advance the President's policy priorities." It also specifically states that federal funding can't go to research that endorses or advocates "for the notion that sex is a chosen or mutable characteristic."

Currently, NIH grant applications go through a two-step review process, which includes both non-federal scientists and the relevant national advisory council or board. Final approval rests with the director of a specific NIH institute or center, such as the National Cancer Institute or the National Institute of Allergy and Infectious Diseases.

The results of a multicenter randomized controlled trial indicate that a short course of systemic antibiotics is noninferior to a long course in patients who’ve undergone orthopedic surgery, researchers reported last week in the New England Journal of Medicine.

Conducted at 25 sites in the United Kingdom, Austria, Germany, Portugal, and Spain, the SOLARIO (Short or Long Antibiotic Regimens in Orthopaedics) trial randomly assigned 500 patients who’d undergone surgery for a confirmed orthopedic infection to receive postoperative antibiotic therapy for a short duration (seven days or less) or a long duration (four or more weeks). Local antibiotics were delivered by a device that was implanted during surgery. The primary outcome was definite treatment failure by 12 months, with a noninferiority margin of 10 percentage points.

Postoperative systemic antibiotic treatment for orthopedic infection typically lasts at least four weeks. 

“Orthopedic infection is usually managed with surgery and prolonged systemic antibiotic therapy,” a team led by investigators from Oxford University Hospitals wrote. “Whether local antibiotics delivered by a product implanted at the infection site during surgery can reduce the duration of systemic antibiotic therapy is unclear.”

Less treatment failure, fewer side effects

Definite treatment failure occurred in 14.1% of patients in the long-duration group and 11.1% in the short-duration group, for a risk difference of –3.0 percentage points, which met the prespecified noninferiority margin. Results of sensitivity analyses were consistent with the primary analysis. 

Potential side effects of antibiotic therapy, a secondary outcome, occurred in 45.2% of patients in the long-therapy group and 17.2% of patients in the short-duration group (risk difference, –28.0 percentage points.)

“The anticipated advantages of short-duration therapy, which include fewer symptoms associated with treatment and shorter durations of hospital stay without an increased risk of death or serious adverse events, were seen in the current trial,” the authors wrote.