Best Use of Antibiotics

Please read no further if you are from Barcelona. You have made up your mind already on this topic! For those of you with an open mind, I would like to question the opinion that ampicillin and ceftriaxone should be first line therapy for enterococcal endocarditis. We have all seen the elderly patient with a prosthetic heart valve and Enterococcus faecalis in their blood. I love these consults because: (a) I know ID input can add a lot to the management of these infections, and (b) I know we are in the long haul and so I will get to know the patient well. But I also groan a little when I get the call because I know we are in for a difficult time - problems include "too old and sick for valve replacement surgery", there is real mortality associated with this infection, and yes, these are the patients in whom aminoglycoside use can be challenging. For those of you who had the pleasure of knowing Bob Moellering, you will recall he was the pioneer of understanding that ent...

Welcome! The purpose of this blog is to critically review new information on antibiotics of relevance to hospital based ID Physicians and Pharmacists. My emphasis is to get beyond data from FDA and EMA registration studies, to data that will really make a difference to ID practice. I don't care if a new antibiotic has data for complicated intra-abdominal infection, but really want to know if it will work in a sick patient with bloodstream infection due to a multiresistant organism. We are entering a fortunate time in which a host of new antibiotics against multiresistant organisms will soon be available. I want to look beyond "the spin" to ensure we use the best antibiotic for each individual patient. If that is a generic and "cheap" antibiotic, let's go for it. If it is a new and expensive antibiotic, let's critically examine the data. One of my interests is going beyond observational studies to ID physician/pharmacist led RCTs that are going to an...