Category AMS strategy

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 […]

CIDRAP Antimicrobial Stewardship Project – online resource

The CIDRAP Antimicrobial Stewardship Project (ASP) is an initiative based out of the University of Minnesota that offers freely available, high-quality information and educational resources on antimicrobial stewardship practice, research, and policy. It features a dynamic, content-rich web site designed to actively engage a diverse, international audience.  Online features include podcasts with Advisory Committee members, […]

AURA 2016 – Australian antimicrobial use & resistance- key findings

The Australian Commission on Safety and Quality in Health Care (ACSQHC) recently released AURA 2016 – Australian report on antimicrobial use and resistance in human health. This detailed report analyses diverse existing national sources of data and underpins Australia’s recently released ‘One-Health‘-style National Antimicrobial Resistance Strategy 2015-2019  and will serve as an important baseline for future AMR […]

Be Medicinewise Week – Take Charge!

This year during Be Medicinewise week the National Prescribing Service (NPS) is encouraging clinicians to promote Australians taking charge of their health by being medicinewise, and raising awareness on the importance of having conversations about medicines. Be Medicinewise week (last week!) suggested clinicians ask patients to keep in mind 3 key pieces of advice to take control […]

Sparing fluoroquinolones – alternative safe and effective options by syndrome and bug

Fluoroquinolones (ciprofloxacin, norfloxacin and moxifloxacin) have serious potential side effects,  and are best used only for directed therapy of serious multi-resistant Gram negative infections where no other safer alternatives are available. 14 of our 32 hospital facilities in HNELHD overuse these agents with 2016 average FQ usage above our current benchmark of 30 defined daily doses per 1000 patient-days. […]

Ciprofloxacin and other fluoroquinolones: should you think twice about prescribing?

Fluoroquinolones (ciprofloxacin, moxifloxacin and norfloxacin) (FQ) are essential agents for directed treatment of certain types of resistant aerobic Gram negative bacterial species where FQ susceptibility  has been proven.  They are best avoided as empirical  therapy or where there is an alternative due to these potential serious side effects:

Recognising and treating skin conditions in Aboriginal and Torres Strait Islander people

The 2016 Northern Territory Healthy Skin Workshop proceedings are available here and have great relevance for all practitioners in other regions (especially Hunter New England) who care for similar patients.  The workshop aimed to develop a framework to enable a coordinated approach to Healthy Skin in the Top End. The proceedings highlight many useful resources and describe […]