Category Journal paper
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 […]
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 […]
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.
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 […]
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 […]
Dosing information for children, unlike adults, is often presented as a mg/kg range. So how do you choose what dose to use?This recent discussion from the BMJ has some important take home messages . Did you know that a child qualifies for an adult antibiotic dose usually by the time they weigh 40 kg? That […]
Guest post from Dr Hema Varadhan, Staff Specialist Microbiology: The focus of palliative care is to provide comfort for patients in their final stages of life. The use of medication should aim to provide this comfort by controlling troubling symptoms. So what role to antimicrobials have, if the intention is not curative?
What is the evidence? This interesting paper from 2010 discusses the natural history of UTI in women and distinguishes two conditions – the ‘urethral’ (or ‘dysuria/frequency’) syndrome’ (US) which affects a proportion of women with recurrent symptoms and many courses of treatment. It is known that US is a self-limited condition in a majority of patients. Some women are said to […]
Reducing ESBL Gram negative fluoroquinolone resistance – what is the ecological sweet spot for usage?
This excellent recent paper from Sarma et al brings focus on what the target level of quinolone use should be in order to have an impact on quinolone resistance in Enterobacteriaceae. It describes the situation across a region of England (9 hospitals and other facilities) where quite stringent control of cephalosporin use was already in place […]