Your recent pathology test showed that you are carrying a strain of resistant Staphylococcus aureus (MRSA) bacteria that occasionally can cause serious infection.  See also this NSW MRSA Fact sheet.    This treatment aims to completely remove the MRSA from your body. In about half of the people treated in this way, the MRSA remains undetectable for yearsand […]

Recurrent staphylococcal infection:  Natural history Virulent strains of Staph. aureus (including golden staph- MRSA) are responsible for recurrent skin and soft tissue infections (eg. boils)in previously well individuals (children and adults). The infections may recur over many months. Eventually some degree of immunity develops and the episodes become less frequent. However episodes may continue to occur for […]

This posting summarises all the work that can be found – I would welcome advice about any additional studies.  Image: Bacteroides fragilis Gram stain from http://microbe-canvas.com/. Australia J Antimicrob Chemother. 1992 Dec;30(6):811-20. Antimicrobial susceptibility of anaerobic bacteria in Australia. Chen SC, Gottlieb T, Palmer JM, Morris G, Gilbert GL. The last survey published in Australia […]

Useful information sheet on alternatives from NCAS. N.B. oral bioavailability of metronidazole is high.  Previously published ANZ anaerobe susceptibility data will be re-published on AIMED soon.

Our JMO pre-test survey also asked “What puzzles you about antibiotics and their use”. A recurring theme was concern about remembering the various classes and names of antibiotics. Here are some useful pointers and a short quiz ! 

Question 3 of our JMO pre-test survey asked about the aims of antimicrobial stewardship (yes, better ‘antimicrobial’ than ‘antibiotic’- antiviral, antifungal, antiparasitic resistance are issues as well). We gave you three options  and all except one responded with the correct answer – all three!  The order is important – treatment of the individual patient comes first: Optimise the effectiveness […]

Q2 in our JMO pre-test asked: “What is the main mechanism by which the bacterium Staphylococcus aureus becomes resistant to penicillin?” We gave alternatives enumerating basic mechanisms that micro-organisms use (often in combination) to become resistant to an antimicrobial agent (graphic below).   Production of penicillinase (i.e. inactivation by a type of beta-lactamase) was the correct answer– more […]

The antibiotic knowledge survey of our new interns this week,  showed that many were confused about which class vancomycin (a glycopeptide) fell into (30% thought it was an aminoglycoside).  This is a potentially dangerous confusion as the dosing, side effects and monitoring all differ substantially between these classes: Aminoglycoside Glycopeptide Indicative agents Gentamicin Vancomycin Dosing […]

In November 2016, a  Dental Antimicrobial Stewardship: toolkit was released.  It was developed in response to findings in the May 2016  Antimicrobial Resistance review by the Dental Subgroup of the English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR).  It complements these existing standards:   General Dental Council (GDC) standards/guidance and Care Quality Commission (CQC) Fundamental Standards.

Poor antimicrobial prescribing decisions often are triggered by laboratory results that create red herrings or worse.  Inappropriate/ poor specimen collection and/or a request form that provides no context to the investigation often sets the ball rolling.  Inappropriate workup and reporting of contaminant or colonising isolates may then follow (it may be impossible for the lab […]