Where all your ID needs are met! Sort of.
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
This and (likely) the next post are a product of questions I got asked. For instance, do you need anaerobic coverage for diabetic foot infections? Depends, but see later. What organisms do you need to cover for cellulitis in those who have had water exposure? Cephalexin and quinolones, with some exceptions. We will talk about
Look, I know I have talked a lot about staphylococcus but there is a ton of details that go into the therapeutic aspects of it. When it comes to staphylococcus aureus bacteremia, specifically MRSA, vancomycin is the first line therapy per the IDSA guidelines (1). I have discussed the issues with vancomycin dosing, and how
I absolutely love this song. I tried to learn how to play it on guitar, but I think you may need 7 strings for it, at least when I checked back in the day. This week we are adding to last week’s topic and talking about when and what type of echo to get. There
At any rate, at approximately one-quarter to twelve that night, I remember distinctly getting up from my chair and from the table, where my books lay, and taking off my suit coat. No sooner had I removed the left arm of my coat, than there was on the ventral aspect of my left wrist a
The use of rifampin for staphylococcal infections is a bit controversial. The recommendation seems to be its use on infections involving prosthetic material, such as prosthetic valve endocarditis or prosthetic joint infections. For instance, the AHA infective endocarditis (1) guidelines recommends the addition of rifampin to a regimen consisting of vancomycin to infectious caused by
I have to admit, this is not a very sexy topic to write about. Indeed, next to diabetic foot infections, these tend to, shall we put it, do not arouse my interest. Nevertheless as the population ages, more and more people will end up with a knee or hip replacement and you are more likely
Staphylococcus Aureus is a tough disease to treat, but luckily for MSSA we have pretty good antibiotics to treat this beast. The choice is usually between cefazolin, a first-generation cephalosporin, and Nafcillin, an anti-staphylococcal penicillin. My experience has been that cefazolin is usually the go to antibiotic for MSSA bacteremia, with nafcillin having a niche
Empiric therapy for patients with pneumonia is not as clear cut as one would think. Guidelines tend to differ in terms of when to start empiric MRSA coverage, with some guidelines recommending initial therapy that covers MRSA in those who are admitted to the ICU (1), while other guidelines suggest to start MRSA therapy if
So MRSA is really hard to kill. If you have done any sort of ID, you will not be surprised by that statement. MRSA bacteremia has a high relapse rate. Because of this, people have tried multiple types of antibiotics, including Daptomycin and Ceftaroline, have been used with minimal change in the outcomes. In the
Dr. Germophile 