On examination in the A&E department he had a swollen, generally tender right knee with decreased range of movement. There was a large effusion with a positive patellar tap. There was also evidence of a small puncture wound in the superomedial aspect of his right knee. He was apyrexic (36.2C) and systemically well. The knee was aspirated under aseptic technique, and 8ml of turbid fluid was samp...

Oral administration of antibiotics for treatment of urinary tract infections (UTIs) can cause ecological disturbances in the normal intestinal microflora. Poorly absorbed drugs can reach the colon in active form, suppress susceptible microorganisms and disturb the ecological balance. Suppression of the normal microflora may lead to reduced colonization resistance with subsequent overgrowth of p...

OBJECTIVES Flexible bronchoscopy with bronchoalveolar lavage (FB-BAL) is increasingly used for the microbiological confirmation of protracted bacterial bronchitis (PBB) in children with a chronic wet cough. At our centre, when performing FB-BAL for microbiological diagnosis we sample 6 lobes (including lingula) as this is known to increase the rate of culture positive procedures in children wit...

Co-amoxiclav is a fixed combination of the sodium salt of amoxicillin (amoxiNa) and the potassium salt of clavulanic acid (clavK). Although clavulanic acid has weak antibacterial activity when used alone, its combination with certain penicillins results in a synergistic effect which expands the spectrum of activity of the penicillin against many strains of beta-lactamase producing bacteria. Pre...

INTRODUCTION A patients with undiagnosed type II diabetes mellitus presented with infective rhinocerebral mucormycosis. INVESTIGATION RESULTS: Initial magnetic resonance imaging scans demonstrated an aggressive disease process involving the left orbit and paranasal sinuses. A repeated scan following treatment excluded intracranial spread or recurrence. Pus from the paranasal sinuses grew Rhizop...

Urinary tract infections (UTIs) are a major source of antimicrobial prescribing in the clinical setting and a potential reservoir for the emergence of resistant organisms. Although studies have been published on resistance rates for urinary pathogens from both hospital and general practitioner (GP) settings, there is little information from Long-Term Care Facilities (LTCFs) in Ireland. This stu...

Introduction Aortic endograft infection is a rare but serious complication following endovascular aneurysm repair. An unusual presentation associated with an uncommon organism is reported. Case report A 69 year old female was prescribed but failed to complete a full course of co-amoxiclav following a forearm cat bite. Nine days later she was admitted with pyrexia, left flank pain, and haematu...

The aim of the study was to identify outpatient antibiotic consumption between Jan 2000 and Dec 2005 through analysis of the HSE-Primary Care Reimbursement Services (PCRS) database as part of the Surveillance of Antimicrobial Resistance in Ireland (SARI) project. Total antibiotic consumption on the PCRS scheme between January 2000 and December 2005 expressed in Defined Daily Dose per 1000 PCRS ...

OBJECTIVES Many European countries have engaged in awareness campaigns to decrease outpatient antibiotic use and several measures have been proposed, e.g. the number of defined daily doses (DDDs) or packages per 1000 inhabitants per day, producing conflicting findings. Therefore, we set out to explore what measure is most appropriate. METHODS Outpatient data on each dispensed and reimbursed m...

We describe a controlled study comparing the effects on primary care prescribing in west Gloucestershire, UK, where antibiotic workshops were offered, with those in east Gloucestershire, where microbiology tutorials were given. The year-on-year changes in quantity and costs of antibiotics dispensed following general practice prescriptions were measured. There was no significant difference in th...