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

Rollo Manning rollom at iinet.net.au
Fri Oct 3 06:40:18 EST 2008


RE: CARPA Digest, Vol 29, Issue 1Where can I get a copy of the Rural Health Essential Drug list?
Thanks
Rollo Manning
  ----- Original Message ----- 
  From: Andrew Bell 
  To: Central Australian Rural Practitioners Association 
  Sent: Thursday, October 02, 2008 1:45 PM
  Subject: RE: [CARPA] RE: CARPA Digest, Vol 29, Issue 1


  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

   


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  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)

   

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

  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

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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>

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  <F79A83F5F064304790B801155F8D6884CEDF52 at aspensyd02.AspenDomain.local>

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