[CARPA] RE: CARPA Digest, Vol 29, Issue 2
Malcolm McDonald
Malcolm.McDonald at menzies.edu.au
Thu Oct 2 14:54:45 EST 2008
Response to David Brookman
1. Pseudomembanous colitis represents the severe end of spectrum of Cl.
difficile diarrhoea. Nevertheless, there has bee a string of fatalities
from Pseudomembanous colitis recently reported from Canada.
2. I NEVER said that oral vancomycin should NEVER be used in
Cl.difficile diarrhoea.
3. Oral vancomycin should NEVER be used for staphylococcal tissue or
systemic infection because it is not absorbed from the gut, there are no
blood or tissue levels and it doesn't work. In other words, giving oral
vancomycin for these infections is the same as giving nothing - it may
be worse because it may delay effective treatment.
4. We have tried using oral vancomycin for treating
antibiotic-associated staphylococcal diarrhoea many years ago (McDonald
et al. Med J Aust 1982;1:426-64). This is a rare event in sick
hospitalised patients. There are no subsequent studies proving benefit
and it is no longer generally recommended.
Best wishes
Malcolm
-----Original Message-----
From: carpa-bounces at ozdocit.org [mailto:carpa-bounces at ozdocit.org] On
Behalf Of carpa-request at ozdocit.org
Sent: Thursday, October 02, 2008 1:53 PM
To: carpa at ozdocit.org
Subject: CARPA Digest, Vol 29, Issue 2
Send CARPA mailing list submissions to
carpa at ozdocit.org
To subscribe or unsubscribe via the World Wide Web, visit
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When replying, please edit your Subject line so it is more specific
than "Re: Contents of CARPA digest..."
Today's Topics:
1. RE: CARPA Digest, Vol 28, Issue 1 - Vancocin capsules
(David Brookman)
2. Re: Vancocin Capsules now in Stock (Geoff Stewart)
3. Poster: How to Get Renal Bloods Right Every Time! (Alex Hope)
4. RE: CARPA Digest, Vol 29, Issue 1 (Malcolm McDonald)
5. Influenza vaccination in pregnancy (Malcolm McDonald)
6. RE: RE: CARPA Digest, Vol 29, Issue 1 (Andrew Bell)
7. RE: RE: CARPA Digest, Vol 29, Issue 1 (Andrew Bell)
----------------------------------------------------------------------
Message: 1
Date: Tue, 30 Sep 2008 19:41:16 +1000
From: "David Brookman" <djsdb8 at bigpond.net.au>
Subject: RE: [CARPA] CARPA Digest, Vol 28, Issue 1 - Vancocin capsules
To: "'Central Australian Rural Practitioners Association'"
<carpa at ozdocit.org>
Message-ID: <000001c922e0$af508c00$0df1a400$@net.au>
Content-Type: text/plain; charset="us-ascii"
Folks, sorry to butt in but how about some rationality in decision
making?
1. What is the incidence of pseuomembranous colitis in remote
communities?
2. What is the incidence of faecal collection for Cl difficile toxin
(and
for that matter immunochemistry for other gut pathogens)? Do they
survive
the specimen transport chain?
3. What is the delay in treatment occasioned by remote communities not
having immediate access to Vancomycin capsules and is this a risk. From
my
experience pseudomembranous colitis is not a life threatening condition
and
a 48 hr delay is inconsequential but I really do not like people making
edicts that something should NEVER happen.
4. What is required by remote communities is injectable vancomycin for
immediate treatment of CAPD associated peritonitis.
David Brookman
-----Original Message-----
From: carpa-bounces at ozdocit.org [mailto:carpa-bounces at ozdocit.org] On
Behalf
Of Julie Parras
Sent: Monday, 29 September 2008 11:00
To: Central Australian Rural Practitioners Association
Subject: RE: [CARPA] CARPA Digest, Vol 28, Issue 1 - Vancocin capsules
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
carpa at ozdocit.org
To subscribe or unsubscribe via the World Wide Web, visit
http://ozdocit.org/cgi-bin/mailman/listinfo/carpa
or, via email, send a message with subject or body 'help' to
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You can reach the person managing the list at
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When replying, please edit your Subject line so it is more specific than
"Re: Contents of CARPA digest..."
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>
Content-Type: text/plain; charset="us-ascii"
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------------------------------
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Message: 2
Date: Wed, 1 Oct 2008 08:50:07 +0930
From: Geoff Stewart <geoffstewart at dragnet.com.au>
Subject: Re: [CARPA] Vancocin Capsules now in Stock
To: Central Australian Rural Practitioners Association
<carpa at ozdocit.org>
Message-ID: <6919DBA1-BDAD-477A-8684-5B36D9940F92 at dragnet.com.au>
Content-Type: text/plain; charset="us-ascii"
I would like to see that when CARPA subscribers get emails about
drugs that generic names are used, if only in the email header or
message (as I realise that this is a big ask of the pharmaceuticals).
I doubt that the govt will launch another intervention on it's
account, but would like to see that the use of generics is a
principle that we continue to support.
Cheers,
Geoff Stewart
On 25/09/2008, at 11:14 AM, Julie Parras wrote:
> Dear CARPA member,
>
> please find attached letter outlining that Vancocin capsules are
> now available again from Aspen Pharmacare
>
> Kind Regards
>
> Julie Parras
> Senior Product Manager
> Aspen Pharmacare
> PH: 61 2 8436 8300
> FAX: 61 2 9901 3540
> <CARPA letter codes vancocin Sept
> 08.doc>_______________________________________________
> CARPA mailing list
> CARPA at ozdocit.org
> http://ozdocit.org/cgi-bin/mailman/listinfo/carpa
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Message: 3
Date: Wed, 01 Oct 2008 13:16:57 +0930
From: Alex Hope <wombat at octa4.net.au>
Subject: [CARPA] Poster: How to Get Renal Bloods Right Every Time!
To: carpa at ozdocit.org
Cc: Rebecca.Johnston at nt.gov.au
Message-ID: <48E2F2B1.3020900 at octa4.net.au>
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Message: 4
Date: Wed, 1 Oct 2008 14:09:11 +0930
From: "Malcolm McDonald" <Malcolm.McDonald at menzies.edu.au>
Subject: [CARPA] RE: CARPA Digest, Vol 29, Issue 1
To: <carpa at ozdocit.org>
Message-ID:
<D12B2C721140D84EA1D99DFD5F705FBA02ADC3DD at CDU-MAIL.cdu-staff.local>
Content-Type: text/plain; charset="us-ascii"
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-----
From: carpa-bounces at ozdocit.org [mailto:carpa-bounces at ozdocit.org] On
Behalf Of carpa-request at ozdocit.org
Sent: Wednesday, October 01, 2008 11:30 AM
To: carpa at ozdocit.org
Subject: CARPA Digest, Vol 29, Issue 1
Send CARPA mailing list submissions to
carpa at ozdocit.org
To subscribe or unsubscribe via the World Wide Web, visit
http://ozdocit.org/cgi-bin/mailman/listinfo/carpa
or, via email, send a message with subject or body 'help' to
carpa-request at ozdocit.org
You can reach the person managing the list at
carpa-owner at ozdocit.org
When replying, please edit your Subject line so it is more specific
than "Re: Contents of CARPA digest..."
Today's Topics:
1. RE: CARPA Digest, Vol 28, Issue 1 - Vancocin capsules
(Julie Parras)
----------------------------------------------------------------------
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
carpa at ozdocit.org
To subscribe or unsubscribe via the World Wide Web, visit
http://ozdocit.org/cgi-bin/mailman/listinfo/carpa
or, via email, send a message with subject or body 'help' to
carpa-request at ozdocit.org
You can reach the person managing the list at
carpa-owner at ozdocit.org
When replying, please edit your Subject line so it is more specific than
"Re: Contents of CARPA digest..."
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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------------------------------
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------------------------------
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Message: 5
Date: Thu, 2 Oct 2008 13:05:04 +0930
From: "Malcolm McDonald" <Malcolm.McDonald at menzies.edu.au>
Subject: [CARPA] Influenza vaccination in pregnancy
To: <carpa at ozdocit.org>
Message-ID:
<D12B2C721140D84EA1D99DFD5F705FBA02ADC7CA at CDU-MAIL.cdu-staff.local>
Content-Type: text/plain; charset="us-ascii"
1. Influenza has an increased morbidity and mortality in pregnancy.
2. Influenza has an increased morbidity and mortality in the first
year of life.
3. Inactivated influenza vaccination is safe in pregnancy.
4. Inactivated influenza vaccination is currently recommended in
pregnancy (The Australian Immunisation Handbook) to protect the mother.
5. In a recently published study in a setting with year-round
influenza (similar to the NT), inactivated influenza vaccine given in
pregnancy substantially reduced proven influenza in infants < 6 months
of age and averted a third of all febrile respiratory illness in
mothers and young infants.
6. We recommended that health practitioners include inactivated
influenza vaccination for pregnant women as part of routine antenatal
care.
References
* The Australian Immunisation Handbook 9th Edition 2008
* Rothberg et al. Complications of viral influenza. Am J
Med 2008; 21:258-64
* Zaman K, et al. Effectiveness of maternal influenza
immunization in mothers and infants. N Engl J Med 2008 (ePublished -
PMID: 18799552)
Dr Malcolm McDonald - Specialist Outreach Physician, Menzies School of
Health Research
Prof Anne Chang - Head, Division of Child Health, Menzies School of
Health Research
Dr Vicki Krause - Director, Centre for Disease Control, DHF (NT)
Dr Ros Webby - Head of Immunisation, Centre for Disease Control, DHF
(NT)
Ms Chris Nagy - Immunisation Project Officer, Centre for Disease
Control, DHF (NT)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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Message: 6
Date: Thu, 2 Oct 2008 13:37:22 +0930
From: "Andrew Bell" <andrew.bell at kwhb.com.au>
Subject: RE: [CARPA] RE: CARPA Digest, Vol 29, Issue 1
To: "Central Australian Rural Practitioners Association"
<carpa at ozdocit.org>
Message-ID: <84D4EA06C5F730419F667D202CFCE5D40C24C9 at Server.KWHB.local>
Content-Type: text/plain; charset="us-ascii"
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-----
From: carpa-bounces at ozdocit.org [mailto:carpa-bounces at ozdocit.org] On
Behalf Of carpa-request at ozdocit.org
Sent: Wednesday, October 01, 2008 11:30 AM
To: carpa at ozdocit.org
Subject: CARPA Digest, Vol 29, Issue 1
Send CARPA mailing list submissions to
carpa at ozdocit.org
To subscribe or unsubscribe via the World Wide Web, visit
http://ozdocit.org/cgi-bin/mailman/listinfo/carpa
or, via email, send a message with subject or body 'help' to
carpa-request at ozdocit.org
You can reach the person managing the list at
carpa-owner at ozdocit.org
When replying, please edit your Subject line so it is more specific
than "Re: Contents of CARPA digest..."
Today's Topics:
1. RE: CARPA Digest, Vol 28, Issue 1 - Vancocin capsules
(Julie Parras)
----------------------------------------------------------------------
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
carpa at ozdocit.org
To subscribe or unsubscribe via the World Wide Web, visit
http://ozdocit.org/cgi-bin/mailman/listinfo/carpa
or, via email, send a message with subject or body 'help' to
carpa-request at ozdocit.org
You can reach the person managing the list at
carpa-owner at ozdocit.org
When replying, please edit your Subject line so it is more specific than
"Re: Contents of CARPA digest..."
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>
Content-Type: text/plain; charset="us-ascii"
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------------------------------
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Message: 7
Date: Thu, 2 Oct 2008 13:45:36 +0930
From: "Andrew Bell" <andrew.bell at kwhb.com.au>
Subject: RE: [CARPA] RE: CARPA Digest, Vol 29, Issue 1
To: "Central Australian Rural Practitioners Association"
<carpa at ozdocit.org>
Message-ID: <84D4EA06C5F730419F667D202CFCE5D40C24CB at Server.KWHB.local>
Content-Type: text/plain; charset="us-ascii"
Sorry my error (before everyone rushes to correct me), IV Vanc. Is on
our Remote Doctors drug list
Andrew
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-----
From: carpa-bounces at ozdocit.org [mailto:carpa-bounces at ozdocit.org] On
Behalf Of carpa-request at ozdocit.org
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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"Re: Contents of CARPA digest..."
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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