N S Uyeda wrote:
> We wonder what antibiotics to report on Salmonella and Shigella, and
> whether to do even do an MIC at all. We do Vitek gram neg. MIC panels.
In routine stool samples susceptibility testing is not always required,
however, I take the attitude that we should perform, record but not
report results unless requested for good clinical reasons. Such reasons
inlcude growth in blood, a severely unwell neonate or even infant, and
immunocompromised patient.
In Darwin we tend to treat alot of our _Shigella_ cases because many are
also malnourished at the same time.
What to report, well we all know aminoglycosides are a waste in these
cases. I report ampicillin (remember amp is better than amox in
_Shigella_), co-trimoxazole and if systemic infection a third generation
cephalosporin. I usually telephone the results anyway and will discuss
with the clinician the case. Sometimes, if they can be managed as an
outpatient, I might prescribe norfloxacin. Of course in _Salmonella_
Typhi I use ciprofloxacin, but in non-Typhi _Salmonella_ without
systemic features I restrict the use of that quinolone.
Hope this helps.
Regards
Gary
--
********************************************************
Dr Gary Lum
Director of Microbiology
Royal Darwin Hospital
Microbiologists do it with culture and sensitivity
Meet me at http://www.ozemail.com.au/~glum/index.html
E-mail me at mailto:glum at ozemail.com.au,gary.lum at nt.gov.au
