(I want to thank my friend and colleague Jeff Karr, DPM (www.osteomyelitiscenter.com) for alerting me to this news story.) Just this past week the U.S. Second Circuit Court of Appeals ruled to prohibit criminal prosecution for truthful off label promotion of drugs as a First Amendment right. An excellent analysis of the case can by … Read more
I wish all of my readers a healthy, happy and prosperous 2012. With this post I am trying something a bit different. In the past I usually waited to put up a post until I come up with an “ah ha” moment on something I have seen, heard or read about which I then pontificate … Read more
As I have mentioned in a previous post there are a number of journals I follow to stay abreast of developments in the ID, microbiology and antibiotic world. For updates on the latest in antibiotic development from pre-clinical through clinical testing no journal beats the American Society of Microbiology’s Antimicrobial Agents and Chemotherapy (http://asm.org/). Just … Read more
For a number of years I have referred in my lectures to the word I have termed “Pseudomonaphobia”. Basically, this is an irrational fear of the organism Pseudomonas aeruginosa (PA) when isolated from a culture of a wound in the foot. I really believe that this arises in most Podiatrists during the residency interview process … Read more
It has been a little while since I asked a clinical question of you, the readers. I actually received a pretty good response last time and some interesting thoughts so I figured I would post a question that was recently asked of me: “What is your opinion on the ‘standard of care’ of the need … Read more
I have blogged a number of times about the questions surrounding some of the unknown, unproven issues surrounding the treatment of osteomyelitis including duration of antibiotic therapy and the “need” for surgical debridement. It continues to amaze me how it does not matter where, or to whom I lecture, if I ask the question “How … Read more
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
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