Guest posting: Dr Jonathan Ash, Infectious Diseases Registrar, John Hunter Hospital, Newcastle, NSW.  A recent single centre retrospective case series from Switzerland examined the clinical characteristics, microbiology and treatment of 97 patients with small native joint septic arthritis. The paper highlights significant differences in the pathogenesis of small joint septic arthritis compared to large joints, […]

A recent paper, “Urinary Tract Infection”-Requiem for a Heavyweight  by Dr Thomas Finucaine skillfully unpacks many key issues, coupling this with a consideration of the emerging knowledge of the urinary microbiome and virome, suggesting that the term “UTI” might better be referred to as a “urinary dysbiosis”.  The paper is worth a detailed read – here […]

Guest posting : Dr Jonathan Ash, Advanced training registrar, John Hunter Hospital. Ventriculitis is a rare but potentially disastrous complication of external ventricular drain placement, and with increasing rates of multi-drug resistant organisms, effective parenteral antibiotic choices are limited. Colistin has an established role in the treatment of infections caused by MDR Gram negatives, particularly […]

SITUATION Due to a global shortage, many Hunter New England Local Health District sites have low supplies of piperacillin+tazobactam with shortages likely until after September. It is essential that further use of this agent is conserved as below.  Amoxycillin+clavulanate is now available in a parenteral form and is a suitable option in many circumstances, contingent on local […]

An  article in The Medical Observer by Dr. Sergio Diez Alvarez of the University of Newcastle comments on alarming trends of antibiotic resistance, the current problems with antibiotic stewardship and potential strategies to improve on reducing resistance. Whilst Dr Alvarez’s article provides some excellent comments for reflection on antibiotic use in humans, it is his discussion regarding […]

Piperacillin+tazobactam (Tazocin) is one of our most important broad spectrum agents and is in short supply. Please conserve it by avoiding use in these common situations: Uncomplicated biliary sepsis  (Use ampicillin+gentamicin(max 48hrs) OR if allergic, ceftriaxone) Urinary tract infection with sepsis (Use ampicillin+gentamicin(max 48 hrs) OR if allergic, ceftriaxone) Early onset (< 5d after admission) […]

We’ve previously counselled against augmentin overuse in a number of conditions which did not, however, include intra-abdominal infection where the new availability of an IV preparation offers us a way of reducing the use of the workhorse antibiotic piperacillin+tazobactam. Here is our freshly minted guideline which also provides more explicit advice about short or no […]

Cumulative antibiograms provide a summary of current bacterial antimicrobial susceptibility for key pathogens in urine and non-urine specimens.  Treatment recommendations based on Therapeutic Guidelines, Antibiotic, Edition 15, 2014 are included in each report. These are prepared by Pathology North, Microbiology for Hunter, New England and Lower Mid-north coast regions. The antibiogram reports include analyses of […]

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 […]

Guest post: Dr Rod Givney, Pathology North Microbiologist.   How well do you know these commonly used drugs, their pros and cons?  Here is an up-to-date overview prepared for our advanced trainee tutorial series. Nitroimidazoles overview 2017 Givney.