Category AMS strategy

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) […]

The old antibiotics are still useful – Fosfomycin

The Special Access Scheme (SAS) allows practitioners to import/gain access to therapeutic goods currently not registered on the Australian Register of Therapeutic Goods (ARTG) for a single patient on a case by case basis. Fosfomycin (one such SAS drug) is a broad spectrum antibiotic belonging to the phosphonic acid derivative drug class (other examples in this drug class include foscarnet and adefovir).

Q3 Tragedy of the commons and antimicrobial stewardship

Question 3 of our JMO pre-test survey asked about the aims of antimicrobial stewardship (yes, better ‘antimicrobial’ than ‘antibiotic’- antiviral, antifungal, antiparasitic resistance are issues as well). We gave you three options  and all except one responded with the correct answer – all three!  The order is important – treatment of the individual patient comes first: Optimise the effectiveness […]

Dental Antimicrobial Stewardship – excellent UK toolkit released

In November 2016, a  Dental Antimicrobial Stewardship: toolkit was released.  It was developed in response to findings in the May 2016  Antimicrobial Resistance review by the Dental Subgroup of the English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR).  It complements these existing standards:   General Dental Council (GDC) standards/guidance and Care Quality Commission (CQC) Fundamental Standards.

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:  

How well do you know antibiotic interactions? Complete our AAW quiz!

Antibiotics are consistently and widely used in almost all areas of clinical healthcare in Australia with 38% of hospital patients being treated with a microbial on any given day (2014) and 46% of the general population being dispensed at least one systemic antimicrobial prescription in the community (2014-2015).   Do you think you’ve got a […]

Proton pump inhibitor addiction – consequences and what can we do?

Proton pump inhibitors (PPIs) are among the most commonly prescribed medications worldwide.  In recent years, there has been a marked increase in prescribing PPIs coinciding with reductions in cost due to patent expiry and generic formulations.  What are the unintended consequences of this addiction and what practical approaches are there to control? 

ANTIBIOTICS: HANDLE WITH CARE

“Antimicrobial resistance is a danger of the utmost urgency. This year will be a pivotal one…We have a global action plan. What we need now is the action” Margaret Chan, WHO Director – General addresses the Executive Board. Report by the Director-General to the Executive Board at its 138th Session Geneva, Switzerland. 25 January 2016

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 […]

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 […]