[CARPA] RE: CARPA Digest, Vol 29, Issue 1

Thu Oct 2 14:07:22 EST 2008

Dear All

As far as I am aware vancomycin oral or IV has never been on our Rural
Health Essential Drug list and I am not aware of any consideration of
adding it. Agree with Malcolm.

Cheers

Andrew Bell

________________________________

From: carpa-bounces at ozdocit.org [mailto:carpa-bounces at ozdocit.org] On
Behalf Of Malcolm McDonald
Sent: Wednesday, 1 October 2008 2:09 PM
To: carpa at ozdocit.org
Subject: [CARPA] RE: CARPA Digest, Vol 29, Issue 1

In reply to Julie Parras

*       Clostridium difficile diarrhoea is rare in the NT community
setting - it is typically a hospital infection - it is also uncommon in
Northern and Central Australian hospitals

*       The current Antibiotic Guidelines recommend metronidazole for
first line treatment of Clostridium difficile diarrhoea - second line is
oral Bacitracin capsules - third line is oral vancomycin capsules 'only
after consultation with an infectious diseases specialist or clinical
microbiologist'. This would be < 5 % of cases of an already rare
disease. 

*       Oral vancomycin is NOT an emergency drug - it can be
driven/flown out to a community in the extremely unlikely event that it
would be needed

*       People whose Clostridium difficile diarrhoea had not responded
to two courses of first line therapy and a then course of second line
therapy should probably be investigated in hospital anyway 

*       There is a sad history of inappropriate use of vancomycin
capsules for staphylococcal infection in settings where doctors and
nurses have been unfamiliar with the various preparations of the drug
(and oral vancomycin has been in stock). In other words it is
potentially dangerous.   

*       The vast majority of Australian hospitals forbid the use of oral
vancomycin capsules in-house unless first approved by an infectious
diseases specialist or clinical microbiologist - usually by telephone 

*       Most health professionals in remote communities have access to a
telephone

Best wishes

Malcolm 

-----Original Message-----
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Sent: Wednesday, October 01, 2008 11:30 AM
To: carpa at ozdocit.org
Subject: CARPA Digest, Vol 29, Issue 1

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Today's Topics:

   1. RE: CARPA Digest, Vol 28, Issue 1 - Vancocin capsules 

      (Julie Parras)

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Message: 1

Date: Mon, 29 Sep 2008 11:00:13 +1000

From: "Julie Parras" <julie.parras at aspenpharmacare.com.au>

Subject: RE: [CARPA] CARPA Digest, Vol 28, Issue 1 - Vancocin capsules

To: "Central Australian Rural Practitioners Association"

        <carpa at ozdocit.org>

Message-ID:

<F79A83F5F064304790B801155F8D6884CEE1C0 at aspensyd02.AspenDomain.local>

Content-Type: text/plain;       charset="us-ascii"

Dear Malcolm, interested in your comments below regarding Vancomycin

capsules should not be made available in remote communities, is this

because they would not have access to an infectious disease specialist?

Also wondered if patients in remote areas do need Vancomycin capsules

how do they get treatment? Sent to area with specialist or simply used

in last resort cases.

I look forward to your comments.

Kind Regards

Julie Parras

Senior Product Manager

Aspen Pharmacare

PH: 61 2 8436 8300

FAX: 61 2 9901 3540

-----Original Message-----

From: carpa-bounces at ozdocit.org [mailto:carpa-bounces at ozdocit.org] On

Behalf Of Malcolm McDonald

Sent: Friday, 26 September 2008 3:21 PM

To: carpa at ozdocit.org

Subject: [CARPA] CARPA Digest, Vol 28, Issue 1 - Vancocin capsules 

It is important to emphasise that vancomycin capsules are NEVER to be

used for treating staphylococcal infection - vancomycin is not absorbed

from the gut. Vancomycin capsules are reserved for third-line treatment

of Clostridium difficile diarrhoea following consultation with an

infectious diseases specialist. 

Vancomycin capsules should not be made available in remote communities.

Malcolm McDonald

Menzies School of Health Research

-----Original Message-----

From: carpa-bounces at ozdocit.org [mailto:carpa-bounces at ozdocit.org] On

Behalf Of carpa-request at ozdocit.org

Sent: Friday, September 26, 2008 11:30 AM

To: carpa at ozdocit.org

Subject: CARPA Digest, Vol 28, Issue 1

Send CARPA mailing list submissions to

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When replying, please edit your Subject line so it is more specific than

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Today's Topics:

   1. Vancocin Capsules now in Stock (Julie Parras)

----------------------------------------------------------------------

Message: 1

Date: Thu, 25 Sep 2008 11:44:16 +1000

From: "Julie Parras" <julie.parras at aspenpharmacare.com.au>

Subject: [CARPA] Vancocin Capsules now in Stock

To: <carpa at ozdocit.org>

Message-ID:

<F79A83F5F064304790B801155F8D6884CEDF52 at aspensyd02.AspenDomain.local>

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