Author Archives: mdjkf

Piperacillin+tazobactam shortage – recommended alternatives – HNELHD

SITUATION Due to a global shortage, many Hunter New England Local Health District sites have low supplies of piperacillin+tazobactam with shortages likely until after September. It is essential that further use of this agent is conserved as below.  Amoxycillin+clavulanate is now available in a parenteral form and is a suitable option in many circumstances, contingent on local […]

Overuse => global shortage! Let’s conserve what piperacillin+tazobactam we have left

Piperacillin+tazobactam (Tazocin) is one of our most important broad spectrum agents and is in short supply. Please conserve it by avoiding use in these common situations: Uncomplicated biliary sepsis  (Use ampicillin+gentamicin(max 48hrs) OR if allergic, ceftriaxone) Urinary tract infection with sepsis (Use ampicillin+gentamicin(max 48 hrs) OR if allergic, ceftriaxone) Early onset (< 5d after admission) […]

IV amoxycillin+clavulanate available – uses in intra-abdominal infection – new guideline

We’ve previously counselled against augmentin overuse in a number of conditions which did not, however, include intra-abdominal infection where the new availability of an IV preparation offers us a way of reducing the use of the workhorse antibiotic piperacillin+tazobactam. Here is our freshly minted guideline which also provides more explicit advice about short or no […]

2016 Hunter New England LHD Cumulative Antibiograms just released

Cumulative antibiograms provide a summary of current bacterial antimicrobial susceptibility for key pathogens in urine and non-urine specimens.  Treatment recommendations based on Therapeutic Guidelines, Antibiotic, Edition 15, 2014 are included in each report. These are prepared by Pathology North, Microbiology for Hunter, New England and Lower Mid-north coast regions. The antibiogram reports include analyses of […]

Is combination therapy with rifampicin for S. aureus bacteraemia a good idea? – highlight from Vienna

Guest posting: Dr Patrick Harris, our roving correspondent at the European Congress on Clinical Microbiology and Infectious Diseases (ECCMID) Conference in Vienna.  At last, an RCT tells us the answer… For many years the evidence-base for things we do routinely in infectious disease has been somewhat sketchy. We are often forced to formulate our recommendations […]

Nitroimidazoles: metronidazole, tinidazole – recent succinct overview

Guest post: Dr Rod Givney, Pathology North Microbiologist.   How well do you know these commonly used drugs, their pros and cons?  Here is an up-to-date overview prepared for our advanced trainee tutorial series. Nitroimidazoles overview 2017 Givney.

Relapse of Staphylococcus aureus bloodstream infection – patient information sheet

Staphylococcus aureus bloodstream infection (septicaemia) information card [Patient Label ] [ [ You were recently diagnosed with a blood infection caused by a bacterium called Staphylococcus aureus (“Golden Staph”). This infection has been treated with intravenous antibiotics. Whilst this usually cures the infection, there is a possibility that your infection could return within 3 months […]

Outpatient MRSA decolonisation instructions

Your recent pathology test showed that you are carrying a strain of resistant Staphylococcus aureus (MRSA) bacteria that occasionally can cause serious infection.  See also this NSW MRSA Fact sheet.    This treatment aims to completely remove the MRSA from your body. In about half of the people treated in this way, the MRSA remains undetectable for yearsand […]

Patient advice: recurrent staphylococcal infection

Recurrent staphylococcal infection:  Natural history Virulent strains of Staph. aureus (including golden staph- MRSA) are responsible for recurrent skin and soft tissue infections (eg. boils)in previously well individuals (children and adults). The infections may recur over many months. Eventually some degree of immunity develops and the episodes become less frequent. However episodes may continue to occur for […]

Anaerobic susceptibility data – Australia and New Zealand and microLab comments

This posting summarises all the work that can be found – I would welcome advice about any additional studies.  Image: Bacteroides fragilis Gram stain from Australia J Antimicrob Chemother. 1992 Dec;30(6):811-20. Antimicrobial susceptibility of anaerobic bacteria in Australia. Chen SC, Gottlieb T, Palmer JM, Morris G, Gilbert GL. The last survey published in Australia […]