Category Myths & Misconceptions

Is combination therapy with rifampicin for S. aureus bacteraemia a good idea? – highlight from Vienna

Guest posting: Dr Patrick Harris, our roving correspondent at the European Congress on Clinical Microbiology and Infectious Diseases (ECCMID) Conference in Vienna.  At last, an RCT tells us the answer… For many years the evidence-base for things we do routinely in infectious disease has been somewhat sketchy. We are often forced to formulate our recommendations […]

Blastocystis- commensal or culprit? Do I really care?

Guest posting from Dr Hema Varadhan, Clinical Microbiologist, Pathology North. This parasite intrigues me every time I validate a faecal PCR result.   Why do we see these bugs more often than the others? Do we care? Do we need to treat?  The RCPA recently provided relevant guidance concerning Blastocystis and Dientamoeba which is also useful […]

How well do you know antibiotic interactions? Complete our AAW quiz!

Antibiotics are consistently and widely used in almost all areas of clinical healthcare in Australia with 38% of hospital patients being treated with a microbial on any given day (2014) and 46% of the general population being dispensed at least one systemic antimicrobial prescription in the community (2014-2015).   Do you think you’ve got a […]

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 […]

Penicillin ‘allergy’ and safety of third generation cephalosporins (ceftriaxone)

A frequent issue is deciding whether a patient with a “penicillin allergy” can safely be given a cephalosporin antibiotic – what is the real risk of cross reaction and is it much less for third generation agents such as ceftriaxone? A recent publication in Prescriber Update from Medsafe New Zealand succinctly analyses cross-reactivity amongst beta-lactam antibiotics in the light […]

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 […]

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 […]

Be Medicinewise Week – Take Charge!

This year during Be Medicinewise week the National Prescribing Service (NPS) is encouraging clinicians to promote Australians taking charge of their health by being medicinewise, and raising awareness on the importance of having conversations about medicines. Be Medicinewise week (last week!) suggested clinicians ask patients to keep in mind 3 key pieces of advice to take control […]

Extrapolating antibiotic susceptibility for streptococci including the pneumococcus

This posting concerns betahaemolytic species of streptococci including S. pyogenes (Lancefield group A strep), S. agalactiae ((group B strep), S. dysgalactiae group (betahaemolytic large colony, groups C or G) (several species included) which are usually associated with pyogenic infection, especially of skin and soft tissue.   S. pneumoniae (the pneumococcus ) is also considered.  A key misunderstanding about […]

Cranberry for prevention and treatment of UTI- placebo or better?

Cranberry juice or cranberry capsules are often recommended for both prophylaxis and treatment of UTIs. As cranberry is associated with only mild side effects and is easy available it seems like it would be a good option, but what evidence is there that shows that it is effective?