Category Antimicrobial

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 […]

Is it cellulitis? The case of itchy red legs

66 year old woman with 12 month history of itchy red  legs. She dated the start of the problem from an excision of a skin lesion from the left shin.  She notes persistent redness occurring over both lower legs, more marked on the left side, and this has been associated with marked itchiness after showering. […]

Extrapolating antibiotic susceptibility for streptococci including the pneumococcus

This posting concerns betahaemolytic species of streptococci including S. pyogenes (Lancefield group A strep), S. agalactiae ((group B strep), S. dysgalactiae group (betahaemolytic large colony, groups C or G) (several species included) which are usually associated with pyogenic infection, especially of skin and soft tissue.   S. pneumoniae (the pneumococcus ) is also considered.  A key misunderstanding about […]

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:

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 […]

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 […]

Sparing meropenem 101: what alternatives exist for the treatment of ESBL-producers?

Guest post: Patrick Harris, Staff Specialist in Microbiology, Central Laboratory, Pathology Queensland, Brisbane In a previous post we looked at bacteria that produce AmpC-type beta-lactamases, such as Enterobacter spp.  Perhaps a more familiar, and increasingly common, problem is presented by species such as E. coli or K. pneumoniae, which have acquired extended-spectrum beta-lactamase enzymes (or ‘ESBLs’).  […]

Should children prescribed antibiotics also take probiotics?

Introduction to Antimicrobial Prescribing- online NPS MedicineWise course

NPS Medicinewise have put together an introduction to appropriate antimicrobial prescribing module for GPs, nurses and students. The activity is free and involves an interactive case study.