Category General Practice

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 […]

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 […]

Antibiotic classes – why so important to know about them?

The antibiotic knowledge survey of our new interns this week,  showed that many were confused about which class vancomycin (a glycopeptide) fell into (30% thought it was an aminoglycoside).  This is a potentially dangerous confusion as the dosing, side effects and monitoring all differ substantially between these classes: Aminoglycoside Glycopeptide Indicative agents Gentamicin Vancomycin Dosing […]

Pathology stewardship – an essential element of AMS

Poor antimicrobial prescribing decisions often are triggered by laboratory results that create red herrings or worse.  Inappropriate/ poor specimen collection and/or a request form that provides no context to the investigation often sets the ball rolling.  Inappropriate workup and reporting of contaminant or colonising isolates may then follow (it may be impossible for the lab […]

Blastocystis- commensal or culprit? Do I really care?

Guest posting from Dr Hema Varadhan, Clinical Microbiologist, Pathology North. This parasite intrigues me every time I validate a faecal PCR result.   Why do we see these bugs more often than the others? Do we care? Do we need to treat?  The RCPA recently provided relevant guidance concerning Blastocystis and Dientamoeba which is also useful […]

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 […]

AAW 2016: practical AMS – popular recent AIMED postings

To kick off Antibiotic Awareness week, here are some favourite postings that you may wish to (re)visit: [BTW, thank you to many who have provided us with constructive ideas and overwhelming positive feedback – please do complete our short survey if you’d like to tell us something!] This posting from pharmacist, Kate O’Hara laid out […]

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 […]