Category Guidelines

Piperacillin+tazobactam shortage – recommended alternatives – HNELHD

SITUATION Due to a global shortage, many Hunter New England Local Health District sites have low supplies of piperacillin+tazobactam with shortages likely until after September. It is essential that further use of this agent is conserved as below.  Amoxycillin+clavulanate is now available in a parenteral form and is a suitable option in many circumstances, contingent on local […]

IV amoxycillin+clavulanate available – uses in intra-abdominal infection – new guideline

We’ve previously counselled against augmentin overuse in a number of conditions which did not, however, include intra-abdominal infection where the new availability of an IV preparation offers us a way of reducing the use of the workhorse antibiotic piperacillin+tazobactam. Here is our freshly minted guideline which also provides more explicit advice about short or no […]

Hunter New England – mobile site for antibiotic guidelines and other

The Hunter New England Local Health District (HNELHD) Quality Use of Medicines mobile-enabled website has recently been updated to include the latest version of some commonly used antibiotic and other guidelines (National and Local). Guidelines available include Surgical Antibiotic Prophylaxis, Community and Hospital Acquired Pneumonia, First-Dose Sepsis, Warfarin prescribing, Heparin Infusion and Potassium Replacement. The […]

New Australasian Guidelines for the treatment of C. difficile

New Australasian Society of Infectious Diseases guidelines for the treatment of Clostridium difficile have been published in the Internal Medicine Journal this month. The guidelines provide management advice for C. difficile in adults and children in both hospital and community settings.

Managing STIs in Primary Care

Guest posting: Dr Nathan Ryder, Clinical Director Sexual Health, Hunter New England Local Health District Managing sexually transmitted infections (STIs) have always presented a number of challenges to primary care physicians. While most bacterial STIs can still be cured with single dose treatments some STIs are becoming increasingly resistant to antibiotics. Therefore it is more […]

AHA infective endocarditis treatment guideline for adults 2015

These American Heart Association recommendations (free online availability) update the 2005 version and continue to incorporate an evidence-based scoring system for all recommendations. Recommendations on diagnosis and on use of echocardiography remain essentially unchanged. Additional information is provided on the therapeutic principles of antimicrobial treatment, including treatment duration and recommendations for specific pathogens. Note that in Australia, […]

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 […]

HNE Guidelines available on Smartphones

The HNEQUM mobile website has recently been updated to include the latest version of some commonly used guidelines.

Essential clinical care of Staphylococcus aureus bloodstream infection (SAB)

201 cases of SAB were managed across Hunter New England Health last year. The overall 30 day all-cause mortality was 22% (30% in those patients 60 years or above).  Relapse of infection occurs in 2-10% of adult patients and may occur up to 3 months after the original bacteraemia. Relapse rates are reduced but not eliminated […]

Choosing Wisely: Antibiotic prophylaxis for prevention of infective endocarditis

For many years, antibiotic prophylaxis was routinely administered before dental and other procedures to patients with cardiac conditions that carry a high lifetime risk of infective endocarditis. However due to the infrequent occurrence of endocarditis, prophylaxis prevents very few cases. Infective endocarditis is more likely to result from bacteraemia associated with daily activities (e.g. tooth […]