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The perils of giving birth in a stable

21/12/2014

It was in the bleak midwinter, when a man led his wife into an inn. They had been riding all day on a donkey, and had travelled a long way because their local Hospital had closed the Maternity Department to cut costs. His wife was close to term and the man was looking for anywhere that had a bed for the night.

“I’m sorry” said the inn keeper, “we have no room at the inn but there is a manger in the stable, if that would do”.

“Gosh!” exclaimed the man, who just so happened to be a slightly paranoid Microbiologist, “I wonder if a stable is compliant with the latest Health Building Notes and Technical Memoranda?”

Be FAMiliar with myasthenia gravis

18/12/2014

Critical Care Units can be noisy at the best of times but on this occasion when I attended, an unplanned intubation was taking place of a patient with community acquired pneumonia (CAP). Microbiologists tend to steer clear of these “noisy” procedures but the team was keen to ask me about escalating the antibiotics because this patient had failed to respond to IV Amoxicillin and IV Clarithromycin, becoming progressively more tired to the point where Critical Care had had to intervene. I asked about any comorbidities, and within the list of other illnesses was the condition myasthenia gravis. I nodded wisely (we Microbiologists like doing this!) and pointed out that the patient had got worse not because of the CAP but because they had been given the wrong antibiotics, in particular Clarithromycin.

All from a mouthful of water!?

11/12/2014

Don't drink the water!

My wife won’t be pleased that I share her story with you but I remember it not so fondly after I have received a few calls regarding the same bug... Giardia lamblia. Jenny and I were white water rafting in Nepal, when the raft over turned. We nearly drowned in the washing machine-like swollen Bhote Koshi River, we both resurfaced downstream and scrambled out onto the river bank but she took a few too many gulps of river water. Alive, breathing and a bit shook up but no lasting harm done...she thought!

No Antibiotics - A NICE idea, but will it work?

4/12/2014

The National Institute for Health and Care Excellence (NICE) has declared its intention to produce new guidelines and quality standards to tackle antibiotic resistance.

Safe and effective antimicrobial stewardship in relation to the use of antimicrobials in health and social care
A public health guideline focused on changing people’s knowledge, attitudes and behaviours in relation to the use of antimicrobials
Quality standards (statements which can be measured) on antibiotic prescribing as part of a suite of new public health quality standards

In my opinion, as a Clinical Microbiologist working on the front line in a UK hospital, I think this is a great idea, but I'm worried that there are a number of big obstacles: lack of clinical microbiology knowledge, previous attempts to reduce antibiotic usage have not stopped increased prescribing, insufficient diagnostics to support clinical decision making, doctors tendency to treat individuals whereas guidelines consider disease in populations, there are no new antibiotics on the horizon and of course, cost of everything versus budget.

The perils of giving birth in a stable

Be FAMiliar with myasthenia gravis

All from a mouthful of water!?

No Antibiotics - A NICE idea, but will it work?

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﻿﻿The perils of giving birth in a stable﻿

Be FAMiliar with myasthenia gravis

All from a mouthful of water!?

No Antibiotics - A NICE idea, but will it work?

Blog Author:

Categories

Archives

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The perils of giving birth in a stable