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It seems I can never get around talking about staphylococcus aureus. I believe it was Paul Sax who mentioned that an infectious disease fellowship is essentially a staphylococcus fellowship, since you see all different types of complications. Many institutions have implemented automatic infectious disease consultation for anyone with staphylococcus aureus bacteremia (SAB), as it has
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
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
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
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
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
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
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
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
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
Dr. Germophile 