Category: Uncategorized

When can bacteremic patients be switched to oral therapy?

Jessica Otte is a tireless improver and her work with Choosing Wisely led her to a very pragmatic question. When can admitted bacteremic patients be safely switched to oral therapy? Here are some pearls. Urinary tract infections Pyelonephritis is the most common source for bacteremia. Many of these patients can be changed to oral therapy […]

Is it time to revisit cefepime?

Not long ago serious infections with E.coli and K. pneumoniae were treatable with a wide variety of antibiotics. The evolution of ESBL and AmpC producing strains has changed things. Now it is common in Canada to see infections with strains that are resistant to all of the “workhorse” hospital antibiotics (ceftriaxone, piperacillin-tazobactam and ciprofloxacin) making […]

Antimicrobial Stewardship in Acute Care Settings

Antibiotics have been used since the 1960s and have been essential in the evolution of modern hospital care. Safe, effective, and relatively inexpensive, their use expanded markedly during the 1970s and 1980s when many “new and improved” antibiotics became available; they were convenient and had a broad range of uses. One new antibiotic, for example, […]

The perils of pet rats

In my 18 months of taking my turn overseeing the Vancouver Island Health Authority diagnostic microbiology laboratory I have been involved in the diagnosis of 3 cases of Streptobacillus moniliformis infection. All three were quite serious requiring several days of hospital care. All three involved pet rats. At least 2 of them were not associated […]

Stewardship is Structure

Certainly in the Canadian context, Antimicrobial Stewardship is a public service. public service noun : the business of supplying a commodity (as electricity or gas) or service (as transportation) to any or all members of a community : a service rendered in the public interest It fulfills both of these dictionary definitions perfectly. Stewardship programs […]

Canada’s big antibiotic problem

Canadians prescribe and take a lot of antibiotics and why not? They are safe. They are effective. They are inexpensive. All good? Not at all. There is a complicated reason why sensible, well-meaning Canadians are making decisions that are harmful to themselves, their neighbours and their children – antibiotic resistance. The more antibiotics we all […]

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