For part 2 of this posting on the new Infectious Diseases Society of America (IDSA) MRSA Guidelines I would like to comment on some of the Executive Summary points made about MRSA bone and joint infections and also vancomycin dosing recommendations. I will use a similar format as before with posting the actual text and … Read more
After an extended, deliberative writing and review process the brand new Infectious Diseases Society of America clinical practice guidelines on the treatment of MRSA have finally been published (full text at http://cid.oxfordjournals.org/content/early/2011/01/04/cid.ciq146.full.pdf+html). I really feel that this document is a MUST READ for anyone interested in treating infections of the lower extremity. For right or … Read more
One of this blog’s readers, Dr. McLeod, asked the following: My question is: Does one need to prescribe antibiotics after I+Ding an abscess? I use to work at a county hospital in Oakland, California where there was a high MRSA rate. At that time (2005), we were being taught not it is unneccessary to prescribe … Read more
Well, the comments have come in and this is what I received – my comments, if any, are in italics: – Interesting question as I just received a memo from the dental school at the University asking my preferences regarding antibiotic prophylaxis with implant (hardware) patients and dental surgery. The letter outlined the 2003 decision … Read more
With this blog entry I am going to try something a bit different. I know that there is a good readership of my posts but, to date, I have been somewhat disappointed in the number of comments and interactions I have received from you, the readers. I stated in my very first post: The whole … Read more
I received this question from a reader: In suspected osteomyelitis do you stop antibiotics prior to obtaining a bone culture? For how long? This comment came in under my entry on the VULCAN trial but I actually covered the question in a post almost exactly a year ago. I am reprinting my response here for … Read more
Well, as I expected and predicted in my previous post, the FDA did not waste much time approving ceftaroline (trade name – Teflaro) for complicated skin and skin structure infections (cSSSI). http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm231594.htm (thanks to Lee Rogers, DPM for forwarding me this link). What does this mean for those of us treating lower extremity infections? It … Read more
For a number of years it was widely felt that the first of the new so-called “5th Generation”, or anti-MRSA cephalosporins would be ceftobiprole. This drug, a joint venture by the Swiss company Basilea and Johnson & Johnson had come under some fire from the FDA (see my blog entry from Dec 31, 2009) and … Read more
Instead of a formal literature review, I just wanted to post a quick clinical comment on something that came up with a patient I saw on consultation in the hospital about 2 weeks ago. This 91 y/o female nursing home resident was admitted with a diagnosis of “cellulitis” of the right foot (of course much … Read more
It is a rare study I read that makes me want to literally stop everything else I am doing and write a blog post about it. It is a dreary, gray Sunday morning and I was just catching up on some backlogged journal reading when I picked up the August 2010 issue of Antimicrobial Agents … Read more