Category AMS strategy
Currently (still in Feb 2018) there is a worldwide shortage of piperacillin+tazobactam , an additional issue to the shortage earlier in 2017 . Appropriate substitutions – see – HNELHD advice (November 2017) JHH_Pip_Taz_Fact_Sheet_Oct_2017 . This includes new dosage recommendations for IV amox+clavulanate for intra-abdominal infection (6 -hrly rather than 8- hrly dosing). For further advice, please contact the […]
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) […]
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 […]
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.
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:
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 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?
“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
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 […]
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 […]