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 […]
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 […]
Recurrent community-acquired Clostridium difficile infection (CDI) – what to do?
A call from a local GP last week – 53 year old woman who was given a course of oral amoxycillin+clavulanate for respiratory infection and then developed moderately severe enteritis associated with CT evidence of colitis. Stool testing for C. difficile toxin genes was positive, confirming a diagnosis of CDI. She responded to a 10 day course […]
New Australasian Guidelines for the treatment of C. difficile
New Australasian Society of Infectious Diseases guidelines for the treatment of Clostridium difficile have been published in the Internal Medicine Journal this month. The guidelines provide management advice for C. difficile in adults and children in both hospital and community settings.
Appendicitis and antibiotics unpacked
Guest posting: Dr Celia Cooper, Paediatric Infectious Diseases & Microbiology, South Australia Pathology, Adelaide Dr Cooper’s recent presentation to the Australian New Zealand Paediatric Infectious Diseases Interest Group in November is provided with her permission. Her presentation highlights important messages: Post-operative antibiotics for patients with non-perforated appendicitis who have acute surgery are unnecessary (refer to IDSA Guidelines […]
Let’s stop using antibiotics for uncomplicated diverticulitis
Guest posting : Dr Daniel Isacson, local GP (ex Swedish researcher) The evidence is out and there is no proven benefit in recovery or complication rates in treating these patients with or without antibiotics, but still many GPs and surgeons prefer to use antibiotics. How do we get the word across?
Helicobacter pylori antibiotic resistance dilemmas and key questions
Helicobacter pylori infection is thought to be the most common bacterial infection worldwide. Whilst the prevalence of H. pylori is decreasing rapidly in Europe, Australia and the USA, where on average 10-15% of the adult population are infected, it remains a significant problem in China, where serological studies in adults still show seroprevalence rates above 70%. Recent data from Auckland, New […]
Micro comments: Clostridium difficile testing
Here are our local Pathology North (NSW) comments together with their rationale: Positive CDI test result comment (no test of clearance required!): The duration of contact precautions following recovery are controversial. Patients will continue to excrete C. difficile for weeks following recovery and can represent a cross infection risk. However continent patients with formed stool who […]