Category Journal paper

Antibiotic gel for acute otitis media – quo vadis?

Chemical engineers at Boston’s Laboratory for Biomaterials have created a single-application bioengineered gel that could deliver a full course of antibiotic therapy for paediatric middle ear infections. While current Australian guidelines state that the vast majority of children do not need antibiotics for otitis media, the gel is claimed to offer hard-to-treat cases a “safer […]

Treatment of boils – Oz GPs reluctant to rely on scalpelmycin rather than antibiotics

Are you following best practice in the management of boils or recurrent skin infection?  We’ve previously addressed this matter detailing a NEJM study that indicated that a majority of US doctors surveyed use incision and drainage only. This recent Australian study investigated treatment of community staphylococcal skin abscesses by GPs and showed that a majority do not follow […]

Acute sinusitis and sore throat in primary care – what evidence?

An excellent paper by Professor Chris Del Mar in Australian Prescriber unpacks the Cochrane reviews on the (quite minimal) value of antimicrobial treatment of these conditions.  The evidence level is quite robust.  For a summary, see below. It couples nicely with a recent pragmatic randomized controlled trial that examined the  effectiveness of steam inhalation and nasal irrigation […]

Why do rates of antimicrobial resistant UTI differ across the world?

It’s well known that rates of antibiotic resistance differ between countries and that previous exposure to antibiotics increases resistance. A recent study in the BMJ looked at rates of resistance in paediatric UTI’s across the globe.

Meningitis: An unexpected adverse effect of antibiotics

Another recent case-control study examining the effects of antimicrobial prescribing on the microbiome and how it affects human health has recently been published. This study aimed to determine if antibiotic prescriptions in the previous year resulted in an increased risk of meningitis.

The post-antibiotic era: A case study

Published in the latest issue of the MJA is a case study of a Victorian patient diagnosed with a carbapenem-resistant Klebsiella pneumoniae. The patient, from rural Victoria, had no history or recent overseas travel and no hospital contact for the last 15 years. He was transferred to a metropolitan hospital for intensive care for severe […]

What does Gram negative rod resistance mean for us clinically?

Enterobacteriacae (gram negative rods) include E. coli, Salmonella and Klebsiella sp. which are important human pathogens. Resistance of the Enterobacteriacae to antibiotics, particularly beta-lactams, is a growing clinical problem. Over use of antibiotics has changed the natural evolution of bacteria creating mobile genes that rapidly spread resistance through populations. Even in countries with controlled antibiotic use have […]

What is the best way to treat skin abscess?

Skin (staphylococcal) abscesses (boils) are often treated with antimicrobials, but are they really needed? The New England Journal of Medicine recently presented a case vignette and asked prescribers to weigh in on whether they thought antibiotics were needed or if incision and drainage alone were enough.

Revised sepsis definitions are a scene changer!

These carefully wrought new definitions potentially revolutionise our approach and will provide greater diagnostic clarity for more rapid recognition and treatment. Highly relevant to all clinicians. Recommendations (JAMA current edition)  Editorial and several other items of note (all free access) Sepsis should be defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. For […]

Sparing meropenem 101 – treatment of ESCPM species and AmpC betalactamases unpacked

Guest post: Patrick Harris, Staff Specialist in Microbiology, Central Laboratory, Pathology Queensland, Brisbane Infectious disease and microbiology trainees diligently learn about organisms that have a type of broad-spectrum beta-lactamase (i.e. an enzyme that can inactivate betalactam antibiotics) called ‘AmpC’.  These enzymes are encoded by a gene that is usually located on the chromosome of many Gram-negative […]