Archive | November, 2011

Double Coverage for Anaerobes

26 Nov

One of our intensivists asked the following:

Is there a need to add metronidazole to cover anaerobes when using Piperacillin/Tazobactam  or meropenem?

Another great question and one frequently encountered with antimicrobial stewardship programs .(1)

The short answer is no.

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Duration of therapy in Community Acquired Pneumonia

18 Nov

While up on the medical unit I was asked by one of our hospitalists what the ideal duration of therapy for CAP is these days.  Is it 10-14 days?

Community –acquired pneumonia (CAP) is the most common infectious disease requiring hospitalization.  The optimal duration of antibiotic therapy for CAP has not been clearly defined.  Previous treatment recommendations for uncomplicated pneumonia ranged from 7 to 14 days and were mostly opinion-based.  I have been unable to find where or why the 7 -14 day durations were chosen.

A recent audit of 2003 patients found that the duration of antibiotic use had little relationship with patients response to treatment or initial severity.  Not surprisingly it also found that prolonged courses of antibiotics for CAP are common (1).

Shortening the duration of antibiotic therapy can potentially reduce antimicrobial use without putting the patient at risk.

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Coming soon

9 Nov

Selective pressure is a blog dedicated to all things related to antimicrobial stewardship and infectious disease.  In the coming days we will begin posting on topics that come up frequently in our current practice. Stay tuned!!