Category Antibiograms

2016 Hunter New England LHD Cumulative Antibiograms just released

Cumulative antibiograms provide a summary of current bacterial antimicrobial susceptibility for key pathogens in urine and non-urine specimens.  Treatment recommendations based on Therapeutic Guidelines, Antibiotic, Edition 15, 2014 are included in each report. These are prepared by Pathology North, Microbiology for Hunter, New England and Lower Mid-north coast regions. The antibiogram reports include analyses of […]

Anaerobic susceptibility data – Australia and New Zealand and microLab comments

This posting summarises all the work that can be found – I would welcome advice about any additional studies.  Image: Bacteroides fragilis Gram stain from Australia J Antimicrob Chemother. 1992 Dec;30(6):811-20. Antimicrobial susceptibility of anaerobic bacteria in Australia. Chen SC, Gottlieb T, Palmer JM, Morris G, Gilbert GL. The last survey published in Australia […]

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 […]

Extrapolating key antibiotic susceptibilities for Staphylococcus aureus

Hunter New England Cumulative Antibiogram Updates reflecting 2015 isolate data

Hot of the press – our updated antibiograms with commentaries – revised format. Some take home messages from these analyses: Gentamicin retains excellent coverage of aerobic Gram negative bacteria and remains the best choice for empirical Gram negative cover, as reflected in the Australian Therapeutic Guidelines: Antibiotic recommendations. The proportion of non-urinary isolates of Staph. aureus […]

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 […]

Vitamin A(minoglycoside): safe use of gentamicin – recommended dosing and monitoring

We rely on the aminoglycoside gentamicin for its rapid bactericidal and broad spectrum action against Gram negative aerobes like E. coli and Klebsiella species.  It’s safety margin is increased in sepsis – the volume of distribution expands. Ototoxicity and nephrotoxocity is almost always due to cumulative effects of prolonged dosing and is minimised through use of […]

What are cumulative antibiograms ?

Antibiograms summarise local antimicrobial susceptibility in order to guide appropriate antimicrobial prescribing. Ideally they are updated annually by microbiology services to provide a current  picture of bacterial susceptibility and the local incidence of key sentinel resistant pathogens.

Updates on Hunter New England infectious disease and antibiotic resistance epidemiology

All Hunter New England cumulative antibiograms have been recently updated for the period 2013_14.  There are separate reports by region, stratified by specimen type (urine cultures vs non-urine samples). Signal resistance analyses are included (for key multi-resistant organisms – MRSA, VRE, MR-Gram negatives).  Overall, the demonstrated antibiotic susceptibility does not demonstrate bacterial resistance levels that go […]