Category Urinary tract infections

The old antibiotics are still useful – Fosfomycin

The Special Access Scheme (SAS) allows practitioners to import/gain access to therapeutic goods currently not registered on the Australian Register of Therapeutic Goods (ARTG) for a single patient on a case by case basis. Fosfomycin (one such SAS drug) is a broad spectrum antibiotic belonging to the phosphonic acid derivative drug class (other examples in this drug class include foscarnet and adefovir).

Micro lab comments: candidaemia and candiduria

Candidal bloodstream infection represents a high risk infection, even for immunocompetent patients. Mortality is significant even for IV line-associated candidaemia.  Blood cultures are seldom contaminated by fungi and any patient with an isolate must be subjected to careful clinical assessment. Our comment serves to give a few reminders that follow on from the liaison between the […]

Ciprofloxacin and other fluoroquinolones: should you think twice about prescribing?

Fluoroquinolones (ciprofloxacin, moxifloxacin and norfloxacin) (FQ) are essential agents for directed treatment of certain types of resistant aerobic Gram negative bacterial species where FQ susceptibility  has been proven.  They are best avoided as empirical  therapy or where there is an alternative due to these potential serious side effects:

Hunter New England Cumulative Antibiogram Updates reflecting 2015 isolate data

Hot of the press – our updated antibiograms with commentaries – revised format. Some take home messages from these analyses: Gentamicin retains excellent coverage of aerobic Gram negative bacteria and remains the best choice for empirical Gram negative cover, as reflected in the Australian Therapeutic Guidelines: Antibiotic recommendations. The proportion of non-urinary isolates of Staph. aureus […]

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.

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?

Antimicrobial prophylaxis, quinolone resistance and prostate biopsy safety

Guest post: Patrick Harris, Staff Specialist in Microbiology, Central Laboratory, Pathology Queensland, Brisbane Overseas travel and prostate biopsies: a key risk-factor for infectious complications with multi-drug resistant bacteria Given an ageing population and the current reliance upon PSA testing to screen for prostate cancer, patients are increasingly being referred for trans-rectal ultrasound (TRUS)-guided prostate biopsies.  Millions […]

Recurrent urinary tract infection in women – are antibiotics the answer?

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 […]

Case report: Community-Acquired Pyelonephritis in Pregnancy Caused by KPC-Producing Klebsiella pneumoniae

In northern NSW, we already face cases similar to that described below – infection with multi-drug resistant carbapenemase-producing Gram negative organisms.  The major global types of these organisms are named with acronyms that refer to the type of carbapenemase gene – KPC, NDM (New Delhi Metallobetalactamase), IMP (imipenemase) and others.  KPC-type organisms are prevalent in Greece, […]

Testing urine from a patient with a urinary catheter – CEC protocol under piloting in NSW

Urines are frequently collected from minimally symptomatic patients.  Detection of bacteriuria and reporting of antibiotic susceptibility is a  frequent prompt for unnecessary antibiotic treatment, especially in residential aged care settings. This new protocol codifies best practice recommendations for collection of urine cultures. It is being trialed at Belmont Hospital in Hunter New England. Clinical Excellence […]