Category Respiratory

Community Acquired Pneumonia – updated HNELHD Guideline

The updated Hunter New England guideline,  Adult Community Acquired Pneumonia: Initial Investigation and Empiric Antibiotic Therapy has now been released. Community acquired pneumonia (CAP) is a common cause of hospital admission, carrying a significant risk of morbidity and mortality.  Approximately 1/3 of patients require admission to hospital.  Streptococcus pneumoniae remains the commonest pathogen ( see here for […]

Bronchiectasis and goals of antibiotic treatment – thinking it through

The setting – patients with bronchiectasis (including those with cystic fibrosis) have impaired respiratory secretion clearance and a vastly different lower respiratory flora (microbiome) than patients with normal lungs.  They are frequently colonised with conventional respiratory species such as Haemophilus influenzae and Moraxella catarrhalis,  Staphylococcus aureus,  a diverse range of Gram negative bacteria and even fungi. Colonisation/infection with non-tuberculous […]

Tazocin misconceptions: misuse in community-acquired pneumonia – spectrum too broad

Piperacillin+tazobactam (Tazocin) is an important broad spectrum antibiotic that is still active in most Australian settings against a wide range of Gram negatives (including Pseudomonas) , Gram positives (excluding MRSA and VRE) and nearly all anaerobic bacteria. It comes into great demand for management of a range of healthcare-associated infections, especially in ICU. Its use […]

Parental Expectations and Otitis Media Antibiotic Prescription

Parental expectations that antibiotics will be prescribed for self-limiting childhood complaints are difficult to overcome. It becomes more difficult when antibiotic prescribing practice differs between prescribers and doesn’t always follow best practice guidelines.  A recent survey of parents with children in playgroup or childcare in Brisbane showed that knowledge about correct treatment of otitis media was […]

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 […]