Author Archives: mdjkf
Is penicillin enough for aspiration pneumonia?
There has been quite a tradition for including Gram negative anaerobic cover for patients suspected to have aspiration pneumonia. There are virtually no randomised trials that directly address the issue with nearly all such trials including agents that have Gram negative anaerobic cover across all treatment arms. One exception was a small trial from 1997 in a paediatric […]
Is ceftriaxone a good anxiolytic for prescribers faced with diagnostic uncertainty ?
The adult presented with 1 week of non-productive cough (yes, a good history was taken), and had no signs of sepsis other than fever. CRP moderately raised, CXR normal. The clinician documented a vague differential diagnosis and started ceftriaxone.
Whip (flagellate) it good: the sound of a bacterium swimming
Scientists synthesise sound of single bacterium swimming – full story. Some mean machine! Dr Ashley Nord and Dr Matt Baker synthesised the sound of this whirring propeller when they attached microscopic polystyrene beads to the flagella of bacteria as part of their research into what makes them spin. The sound you can hear is perhaps more […]
Vitamin ‘C1’ – cefazolin, cephalexin and cephalothin unpacked
These so-called first generation cephalosporins (C1) remain important agents for skin, soft tissue and urinary tract infections due to susceptible organisms and for surgical prophylaxis. Increases in community acquired MRSA in some regions may lead to a different empiric choice for skin/soft tissue infection (e.g. doxycycline or trimethoprim+sulphamethoxazole). Local cumulative antibiograms should also be examined to […]
How long would it take for E. coli to outweigh the universe?
Escherichia coli reproduces every 20 minutes when nutrients are plentiful.
Human metapneumovirus causes severe pneumonia at any age
Further to another hMPV case managed in one of our intensive care units (an adult with acute COPD deterioration), I’m sharing this presentation concerning local experience with hMPV infections that also summarises current hMPV knowledge. Metapneumovirus presentation 2014 im id meeting. Picture: acute severe pneumonia due to human Metapneumovirus infection in an 82 year old diabetic […]
Maximising the value of blood cultures
Blood cultures give a critically important window on bacterial and fungal sepsis, providing direct patient treatment guidance and reliable antimicrobial susceptibility data that are used to construct cumulative antibiograms and empirical treatment guidelines. They also help to rule out serious bacterial infection, provided that collection occurs prior to antibiotic treatment and an adequate patient sample is taken. Here […]
How many of your “cells” are actually of human origin?
The normal adult human body is composed of approximately 10^13 cells.
Choosing Wisely: Antibiotic prophylaxis for prevention of infective endocarditis
For many years, antibiotic prophylaxis was routinely administered before dental and other procedures to patients with cardiac conditions that carry a high lifetime risk of infective endocarditis. However due to the infrequent occurrence of endocarditis, prophylaxis prevents very few cases. Infective endocarditis is more likely to result from bacteraemia associated with daily activities (e.g. tooth […]
What is the most abundant organism on Earth? Not what you’d think!
Tailed phages are a kind of bacteriophage— viruses that infect bacteria. They are the most abundant organism on Earth, with an estimated 10^31 particles in our biosphere.
AIMED - Let's talk about antibiotics 