Category Journal paper

Not in my backyard: whose problem is antimicrobial resistance?

Antimicrobial resistance has been identified as a problem that affects all parts of society. Resources from health organisations and governments are being set aside to combat this problem. One of the most important factors in improving antimicrobial prescribing is education of frontline clinicians. A systematic review of clinicians’ knowledge and beliefs about antibiotic resistance was […]

Paediatric Antimicrobial Stewardship

While children and adults have different antimicrobial needs, antimicrobial stewardship (AMS) principles are the same. There is much less information regarding the implementation and effectiveness of AMS in paediatric hospitals. An Australian-wide point prevalence survey in paediatric hospitals identified 28% of reviewed patients having at least one prescription that was considered to be inappropriate. Prescriptions were considered inappropriate […]

Managing Paediatric Sepsis

Managing paediatric sepsis is difficult. Children require different drugs and doses and the typical pathogens vary across age groups. The team at the BMJ have put together a review of the management and treatment options for children, including neonates. Antibiotics are the only treatment of proven value in paediatric sepsis. Progression to organ failure and shock can be rapid […]

How long should we treat Intra-abdominal Infections for? RCT evidence

A recent randomised trial has shown that patients who receive fixed duration antibiotic therapy (approximately 4 days) had similar outcomes to patients who received longer courses (approximately 8 days). 518 patients with complicated intra-abdominal infections were recruited. Patients received either a fixed course of antibiotics or antibiotics until 2 days after the resolution of fever, leucocytosis […]

Antimicrobial resistance as a social problem.

An observation has been published in the BMJ this week suggesting that the overuse of antibiotics is a social problem and we need to reverse our dependance on antibiotics regardless of the discovery of new drugs. Social aspects of antibiotic overuse identified include: The ways farmers, vets, and regulatory systems manage livestock production for human consumption […]

Antibiotic Treatment Strategies for Community-Acquired Pneumonia in Adults

There is limited evidence comparing different antibiotic treatment strategies for patients with clinically suspected community acquired pneumonia patients who are admitted to non-intensive care beds. A study of 2283 patients in the Netherlands has compared treatment outcomes between patients treated with beta-lactam monotherapy, beta-lactam-macrolide combination therapy and fluroquinolone monotherapy. In this study beta-lactam monotherapy was […]

Antibiotic Prescribing for the Future: GP Registrar Attitudes to Antibiotic Prescribing

The majority of antibiotic prescriptions in Australia are written in primary care. Educational interventions have had limited success at improving prescribing practice. Primary care clinicians are in the difficult position of trying to balance best practice against patient satisfaction. A group of Australian GP registrars were involved in discussions to determine the barriers to appropriate […]

Delaying antibiotic prescribing strategies

There are several strategies than can be used when doctors are reluctant to issue antibiotic prescriptions. You can ask patients to get back in touch is they don’t improve, post-date prescriptions, ask patients to come back and collect the prescription if they aren’t feeling better, write the prescription and ask the patient to delay using […]

A cautionary tale: High usage of topical fusidic acid and rapid clonal expansion of fusidic acid-resistant Staphylococcus aureus

Clinical Infectious Diseases 2014 New Zealand report Researchers from the University of Auckland report that New Zealand, has now developed world’s highest rates of MRSA to topical antibacterial agents.

Cotrimoxazole increases risk of sudden death in patients receiving renin-AT inhibitors

Co-trimoxazole and sudden death in patients receiving inhibitors of renin-angiotensin system: population based study | The BMJ