Category Hospital 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 […]

AAW 2016: practical AMS – popular recent AIMED postings

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 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 […]

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 […]

Sparing meropenem 101: what alternatives exist for the treatment of ESBL-producers?

Guest post: Patrick Harris, Staff Specialist in Microbiology, Central Laboratory, Pathology Queensland, Brisbane In a previous post we looked at bacteria that produce AmpC-type beta-lactamases, such as Enterobacter spp.  Perhaps a more familiar, and increasingly common, problem is presented by species such as E. coli or K. pneumoniae, which have acquired extended-spectrum beta-lactamase enzymes (or ‘ESBLs’).  […]

More Choosing Wisely recommendations released today

Choosing Wisely Australia is an organisation that aims to improve the quality of healthcare provided to Australians by urging healthcare providers to reconsider tests, procedures or treatments where the evidence suggests no benefit or may lead to harm in some cases. Today the organisation released 50 new recommendations from 12 new Australian professional bodies to […]