Author Archives: mdjkf
Antibiotic classes – why so important to know about them?
The antibiotic knowledge survey of our new interns this week, showed that many were confused about which class vancomycin (a glycopeptide) fell into (30% thought it was an aminoglycoside). This is a potentially dangerous confusion as the dosing, side effects and monitoring all differ substantially between these classes: Aminoglycoside Glycopeptide Indicative agents Gentamicin Vancomycin Dosing […]
Blastocystis- commensal or culprit? Do I really care?
Guest posting from Dr Hema Varadhan, Clinical Microbiologist, Pathology North. This parasite intrigues me every time I validate a faecal PCR result. Why do we see these bugs more often than the others? Do we care? Do we need to treat? The RCPA recently provided relevant guidance concerning Blastocystis and Dientamoeba which is also useful […]
AIMED – 5 Moments of Antimicrobial Prescribing
What does AIMED stand for? https://aimed.net.au/about . Kearney standing proud at the Antibiotic Awareness Week displays at Calvary Mater Hospital this week:
AIMED user survey
We focus on practical discussions and guidance concerning AMS topics that are relevant to hospital and community practice. We’d appreciate your feedback and suggestions – using this very short survey. Thank you, Sim and John December: This survey is now closed – thanks to those 25 who responded.
Wasted spectrum 101 – amoxicillin+clavulanate overuse
Amoxicillin+clavulanate (Augmentin) is an important broad spectrum agent that includes Gram negative anaerobic coverage (see below). We rely on it for a variety of complex infections, often as a second line. Compared with amoxycillin alone, the incidence of gastrointestinal, hepatic and haematological side effects is significantly higher for amoxicillin+clavulanic acid. It may be associated with a […]
Treatment of boils – Oz GPs reluctant to rely on scalpelmycin rather than antibiotics
Are you following best practice in the management of boils or recurrent skin infection? We’ve previously addressed this matter detailing a NEJM study that indicated that a majority of US doctors surveyed use incision and drainage only. This recent Australian study investigated treatment of community staphylococcal skin abscesses by GPs and showed that a majority do not follow […]
Micro lab comments: candidaemia and candiduria
Candidal bloodstream infection represents a high risk infection, even for immunocompetent patients. Mortality is significant even for IV line-associated candidaemia. Blood cultures are seldom contaminated by fungi and any patient with an isolate must be subjected to careful clinical assessment. Our comment serves to give a few reminders that follow on from the liaison between the […]
Is it cellulitis? The case of itchy red legs
66 year old woman with 12 month history of itchy red legs. She dated the start of the problem from an excision of a skin lesion from the left shin. She notes persistent redness occurring over both lower legs, more marked on the left side, and this has been associated with marked itchiness after showering. […]
Acute sinusitis and sore throat in primary care – what evidence?
An excellent paper by Professor Chris Del Mar in Australian Prescriber unpacks the Cochrane reviews on the (quite minimal) value of antimicrobial treatment of these conditions. The evidence level is quite robust. For a summary, see below. It couples nicely with a recent pragmatic randomized controlled trial that examined the effectiveness of steam inhalation and nasal irrigation […]
AIMED - Let's talk about antibiotics 
Magical thinking- do antibiotics improve chronic wound healing?
We’ve previously addressed this topic here. It’s certainly the case that chronic skin ulcers (leg or elsewhere) drive an enormous amount of antibiotic prescribing, perhaps because these ulcers are so hard to heal and a degree of therapeutic impatience occurs. The annual survey of chronic wounds last year in our health district indicated that 28% of inpatients […]