HIV and ID Observations

September 11th, 2012

Are Fluoroquinolones Really More Dangerous Than Other Antibiotics?

In today’s New York Times, health writer Jane Brody slams quinolone antibiotics: Part of the problem is that fluoroquinolones are often inappropriately prescribed. Instead of being reserved for use against serious, perhaps life-threatening bacterial infections like hospital-acquired pneumonia, these antibiotics are frequently prescribed for sinusitis, bronchitis, earaches and other ailments that may resolve on their own or can be […]

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March 30th, 2012

Our Obsession with Dental Antibiotic Prophylaxis and an E-mail from Mom

I have a regular, highly efficient email correspondence with my mother — who never really liked talking on the phone to begin with (neither do I), so email is perfect for us. The topics we cover are mostly family stuff, and food — she’s a food writer, after all, so it might be a recipe worth […]

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February 14th, 2012

Is It Time To Stop Treating Acute Sinusitis?

From the pages of JAMA comes this startling clinical trial: A randomized, placebo-controlled trial of adults with uncomplicated, acute rhinosinusitis [who] were recruited from 10 community practices in Missouri between November 1, 2006, and May 1, 2009 … [Subjects received a] ten-day course of either amoxicillin (1500 mg/d) or placebo administered in 3 doses per day … There was no […]

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August 31st, 2011

It’s Time for Antibiotic Placebos

As I’m sure you all agree, it’s high time we had a good antibiotic placebo. Just think — we’d be able to prescribe a 100% effective treatment for viral respiratory tract infections, with the assurance of no risk of antibiotic resistance, C diff, allergic reactions, tendon ruptures, photosensitivity, drug-drug interactions, or any of the myriad other […]

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December 9th, 2010

Chronic Lyme Tough to Diagnose, Tough to Treat

Over at the Chicago Tribune, there is this superb review of the Chronic Lyme disease issue. Lyme disease is real. The bacterial infection, chiefly transmitted by deer ticks, can cause rashes, swollen joints and inflamed nerves, and usually is curable with a round of antibiotics. But doctors around the country are telling patients with common medical problems […]

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November 17th, 2010

Ferlater Antibiotics

In this absolutely hysterical, laugh-out-loud comedy routine, Mal Z. Lawrence describes a woman at a Catskill hotel, piling danish into her handbag. She calls them “ferlater danish” — as opposed to the ones she’s eating at breakfast, those are “fernow.” Did you ever have one of your patients request “ferlater” antibiotics?  That is, ask that you write […]

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October 22nd, 2010

How to Figure Out the Length of Antibiotic Therapy

One thing we ID doctors know — that other clinicians simply don’t — is how long to treat a patient with antibiotics. I was reminded of this special power by these recent events: An excellent fellow from the hospital’s Critical Care program rotated through our division recently.  When asked about what she wanted learn from the elective, the […]

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November 20th, 2009

Ties Tied to Bugs

Are doctors’ neckties causing infections?  That’s the implication of this Wall Street Journal piece: The list of things to avoid during flu season includes crowded buses, hospitals and handshakes. Consider adding this: your doctor’s necktie. … A 2004 analysis of neckties worn by 42 doctors and medical staffers at the New York Hospital Medical Center of […]

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April 18th, 2009

Ceftriaxone and Calcium — OK Again in Adults!

As every house officer, hospitalist, intensivist, and ID doc knows, ceftriaxone and calcium have been contraindicated since 2007 due to fears of a potentially fatal precipitation of the two that led to the death of 5 neonates. Pediatricians are fond of saying “kids are not small adults” (I should know), and if that’s true, it’s even […]

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December 31st, 2008

Free Antibiotics!!!

Yes, the northeast supermarket/pharmacy chain Stop & Shop will now offer antibiotics — for free.  (And they are not the first.  Take a look at this amazing advertisement.) Says Stop & Shop’s “consumer advisor” Andrea Astrachan: Stop & Shop pharmacies are committed to improving the health and wellness in our communities during the winter season when families are susceptible to coughs, […]

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