Category: Antibiotics

Cefepime-Induced Neurotoxicity

It should come to the surprise to no one that antibiotics tend to be the class of medications most commonly prescribed. From the “z-pack” to “augmentin” and the quinolones, they are a mainstay for outpatient and inpatient medicine. On the inpatient side, it is common to see the combination of vancomycin and piperacillin-tazobactam as an

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The Trojan Horse of Antibiotics

I reckon it’s time to write about new antibiotics. I do not like beta-lactamases. Mostly due to their ability to confuse clinicians, however also because it makes it difficult to pick an antibiotic for certain infections. I have written extensively about these, so look at this post. In general, carabepenemases and cephalosporinases within class A

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Cephamycins: The Odd Sibling of the Cephalosporin Family

The cephalosporins are a class of beta-lactam antibiotics that is generally classified based on “generations.” These denote the spectrum of bacteria they target, with each successive generation having more gram negative coverage. I am convinced most people only know about ceftriaxone, the prototype third-generation cephalosporin aka an “extended-spectrum beta lactam” along with cefepime, which is

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Ahorita-que? The New Gram Positive Antibiotic, Oritavancin

Vancomycin is the work-horse antibiotic every person reaches for. It is a glycopeptide that covers a wide range of gram positive bacteria, with its niche being in its coverage of methicillin-resistant staphylococcus aureus and Enterococcus spp. It is bacteriostatic, with dosing issues and highly nephrotoxic, however it is ubiquitous throughout any hospital in the United

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Neutropenic Fever – I Need The Vancz

Neutropenic fever, defined as a single temperature 38.3C (101F) OR 38.0C (100.4F) for one hour in patients whose granulocyte count are <500 cells OR <1000 cells with an expected decline to <500 over the next 48 hours. This is actually a fairly frequent occurrence in those who undergo intensive chemotherapy, especially in hematological malignancies, which

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Daptomycin for Septic Pulmonary Emboli? Maybe

The hits keep coming and they don’t stop coming. I’ve had a bit of a lull lately, but am back to bring short, and hopefully, sweet post. Daptomycin has become a go-to antibiotic for MRSA infections, namely bacteremia, as organisms with resistance to vancomycin have risen in the past few years. The 2006 Fowler study

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What the MRSA PCR? The Role of Nose PCR Swabs in Stewardship.

I recently wrote about the fact that all pneumonia are aspiration events. Depending on the colonization of the oropharynx and the volume of aspirate material plays a role in the development of subsequent disease. It stands to reason that, if we are able to figure out what is colonizing the oropharynx, we may be able

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Is it Aspiration Pneumonia or Aspiration Pneumonitis?

Aspiration of any content is one of those nebulous things we tend to treat, no matter what. The idea is that aspiration of any oropharyngeal contents into the lungs represents an establishment of a new infection and, thus, it needs to be treated. I think the term aspiration pneumonia is actually misunderstood, and it may

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What to do with MDR Acinetobacter Baumannii?

Here in the DrGermophile ranks, we talk about all beta-lactamases and how awesome they are. In particular, we like sulbactam. It is in combination with ampicillin, and its use is unappreciated to the uninitiated, but it plays a role in infections such as anaerobic pneumonia. It has a reasonably broad spectrum of activity, losing out

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Resistance is Futile, For Now – Overcoming Resistance with Ceftazidime-Avibactam

I think we can all agree that resistance is inevitable, despite what the quote says, in the world of infectious diseases. More and more, the use of broad spectrum antibiotics (looking at you, vanco-zosyn!) brings upon more resistant organisms, with beta-lactamases being one of the key methods of resistance in many gram negative bacteria. As

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