Category Guidelines

Carbapenemase-producing Gram negatives – what are treatment options?

Guest posting from Professor Josh Davis, Infectious Diseases, John Hunter Hospital, NSW and Menzies Institute , Darwin, Dr Patrick Harris , NHMRC Early Career Fellow at The University of Queensland Centre for Clinical Research (UQCCR) Carbapenemase-producing Enterobacterales (CPE),  Pseudomonas aeruginosa and Acinetobacter baumannii are usually resistant to most other antibiotics in addition to meropenem.  Treatment […]

Prosthetic joint surgery – HNE Health infection prevention protocols

Preoperative evaluation and perioperative care  Screen for MSSA or MRSA carriage with a single nose swab culture (repeat if surgery delayed > 1 month) Carriers of MSSA or MRSA have staphylococcal load reduction performed in the week prior to surgery Preoperative urine cultures are NOT indicated Shower on day of surgery (normal soap) Apply non-rinse […]

Essential clinical care of Staphylococcus aureus bloodstream infection (SAB)

Originally posted on AIMED – Let's talk about antibiotics:
Updated 8/5/20. A. Healthcare-associated events (2018, HNE LHD ) 60 healthcare-associated SAB cases occurred with 7% due to methicillin-resistant Staphylococcus aureus (MRSA) and age-adjusted 30 day mortality of 9%. SAB relapse within 15-90 days occurred in 2.1% of adult events 7% of paediatric events. Principle…

Smartphone website for local guidelines including pneumonia (HNELHD)

The  Quality Use of Medicines smartphone-enabled website has been updated to include changes to hospital acquired pneumonia guidelines. With this site, you are only three clicks away from a treatment recommendation!  See below for the range of guidelines available. Note that whilst Therapeutic Guidelines: Antibiotic remains the main resource, HNE guidelines, where approved, take precedence- […]

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 […]

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 […]