Author Archives: mdjkf
Ten infection prevention commandments for medical staff
Thanks Craig Boutlis who helped me develop these some time back. Nothing has changed much yet! Always disinfect your hands with alcohol-based hand rub BEFORE and AFTER touching a patient or performing a procedure. Set the example for your team and expect others to follow your lead. Dress well for safer care – abandon ties […]
GP HealthPathways released for recurrent Staph. infection, MRSA and MDRO
The HealthPathways site (based on a model from Christchurch, NZ) are used by our local General Practitioners and others to guide management of common syndromes and to provide guides to hospital-based services. MRSA and MDRO (multi-drug-resistant organism) pathways provide guidance in keeping with MDRO management recommended across Hunter New England Health District . The Recurrent Staphylococcal Infection pathway includes […]
Appropriate use of azithromycin
Azithromycin is a macrolide antibiotic with broad-spectrum bacteriostatic activity against many Gram-positive and Gram-negative bacteria. It also has activity against Mycoplasma pneumoniae, Treponema pallidum, Chlamydia sp. and Mycobacterium avium complex. In addition azithromycin has immunomodulating effects and is used in chronic respiratory inflammatory diseases, including cystic fibrosis, as an anti-inflammatory.
Acute infections that present with a normal or low white cell count (doxycycline deficiency!)
There is a long list that will vary according to your locale. Across Northern NSW, the important ones to consider include: Viral illnesses including influenza, adenovirus, viral hepatitis, parvovirus, EBV and CMV Rickettsial disease (spotted fevers, rarely murine typhus). See useful information page from NSW Health. Q Fever (Coxiella burnetti) (low platelets often, moderately abnormal […]
Infectious diseases 101
Some personal thoughts : Know well important bacterial pathogens such as Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Mycobacterium tuberculosis. Know your antibiotics and again, know a lot about the few that you will commonly use. Aminoglycoside and vancomycin dosing and administration require particular focus – Therapeutic Guidelines: Antibiotic , […]
Do you really need to finish that antibiotic course?
Professor Lyn Gilbert started a discussion going with her recent MJA piece. Health and Wellbeing (ABC) took up the discussion with a further piece teasing out some of these issues- Antibiotics – when is enough enough? Full text below. The community discussion that followed on the ABC News Facebook page was very interesting and diverse! […]
Is it really cellulitis? – differential diagnosis of a red leg
Cellulitis is frequently over-diagnosed. Clinical signs need to include more than just redness – other indications of inflammation are required for diagnosis – e.g. tenderness, pain, swelling, lymphangitis. The onset and progression of the disorder is also a good pointer – streptococcal cellulitis has a rapid onset usually with rapid expansion of the erythematous zone. New […]
Cellulitis 101 – importance of routine skin care
Many patients with lower limb cellulitis have pre-existing venous stasis dermatitis, solar damage or other skin conditions that impair the natural skin barrier.
Avoiding unnecessary urine cultures and treatment
Urine samples are often submitted seemingly without a clear clinical justification. As bacteriuria is a common finding in the elderly, diabetic patients and patients with longterm indwelling or suprapubic catheters, a lab report with a positive culture might then prompt unnecessary antibiotic treatment. The following guide might assist:
Flucloxacillin is highly effective against Streptococcus pyogenes (group A strep) and related species
A common myth – “Flucloxacillin and penicillin in combination are required to treat cellulitis” NOT TRUE: monotherapy is adequate.
AIMED - Let's talk about antibiotics 