Category General Practice

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 […]

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 […]

Antibiotic gel for acute otitis media – quo vadis?

Chemical engineers at Boston’s Laboratory for Biomaterials have created a single-application bioengineered gel that could deliver a full course of antibiotic therapy for paediatric middle ear infections. While current Australian guidelines state that the vast majority of children do not need antibiotics for otitis media, the gel is claimed to offer hard-to-treat cases a “safer […]

Lablogatory – medical pathology unpacked – a great clinical resource

If you have a curiosity about what actually goes on in a medical pathology lab. and matters pathological, then this is the site for you. There are fabulous clinical case presentations with detailed pathological correlation (many great photos) –  just the thing for medical post graduate students but also great for others involved with diagnosis and treatment […]

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 […]