Category Hospital practice
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.
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 […]
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 […]
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 […]
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 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?
“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
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 […]
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 […]
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 […]