Category HNE LHD

Preoperative nasal screening for Staph. aureus carriage and load reduction (HNE LHD)

Indications for preoperative screening for Staphylococcus aureus (MSSA or MRSA) nasal carriage and preoperative staphylococcal load reduction (HNE LHD): Open cardiac and valve procedures Shoulder, hip or knee joint total arthroplasties: primary or revision procedures Aortic work (stent and open) and all lower limb open surgery for vascular reconstructions (bypass, endarterectomy). Iliac stents (as they […]

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- […]

2017 Cumulative Antibiograms are released – HNE, MNC and Northern NSW

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 the commentaries. These are prepared by Pathology North, Microbiology for Hunter, New England, Northern NSW and Lower Mid-north coast regions. The detailed antibiogram reports are […]

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 […]

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 […]

Metronidazole IV in short supply til late May-(Australian advice)

Useful information sheet on alternatives from NCAS. N.B. oral bioavailability of metronidazole is high.  Previously published ANZ anaerobe susceptibility data will be re-published on AIMED soon.

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. […]

Hunter New England Cumulative Antibiogram Updates reflecting 2015 isolate data

Hot of the press – our updated antibiograms with commentaries – revised format. Some take home messages from these analyses: Gentamicin retains excellent coverage of aerobic Gram negative bacteria and remains the best choice for empirical Gram negative cover, as reflected in the Australian Therapeutic Guidelines: Antibiotic recommendations. The proportion of non-urinary isolates of Staph. aureus […]

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 […]