Antibiotic susceptibility testing is commonly used to select appropriate antimicrobial therapy or deescalate to a narrower spectrum agent. Because not every antibiotic is tested, clinicians must infer certain types of antibiotic susceptibility based on bacterial patterns of resistance and sensitivities of other antibiotics.
The following are 8 quick tips regarding inferred antibiotic susceptibility, which are based on the EUCAST clinical breakpoints document (see references). Continue reading
Converting between equianalgesic opioid dosing isn’t exactly a hard science. Given the lack of blinded trials, bidirectional conversions, dose-dependent conversions, incomplete cross-tolerance, equianalgesic discrepancies in the literature, and patient-specific factors (specifically metabolism and absorption), a “simple” equianalgesic conversion table often doesn’t do the process justice. Continue reading
ICU Trials, a mobile app outlining some of the most landmark clinical trials in critical care, is now available for iPhone and Android! Come check out the features and screenshots in all their glory at the ICU Trials for ClinCalc website.
The WARFASA trial, recently published in the NEJM, examined the role of aspirin after patients with VTE’s had completed 6-18 months of warfarin therapy. Given the safety of the treatment and the impressive reduction in VTE recurrence, it’s very likely that the results of the WARFASA trial will find their way into the next CHEST guideline updates. Continue reading
Update March 29, 2014: Vancomycin Calculator for Android and iPhone had received a significant upgrade in both user interface and functionality. Due to developer time and cost, the lite version has been removed from both markets and the paid version price has increased to $2.99. See all the features of the mobile Vancomycin Calculator by clicking here.
Dosing weight-based medications in obese patients can often be a tricky proposition. Most medications do not have guidelines for morbidly obesity, forcing clinicians to pursue in-depth literature searches in order to decide on a dose. This is not only time consuming, but not having an accurate idea of how to dose a medication can be a problem with patient safety.
For the newest addition to ClinCalc, I have created a Drug Dosing in Obesity Reference Table page that will serve as a dynamic growing repository of evidence-based recommendations regarding medication dosing in obese patients. Enjoy! Continue reading
Aminoglycosides have a narrow therapeutic window necessitating therapeutic drug monitoring for safe and effective use. Either fortunately or unfortunately, their use has fallen out of favor and many clinicians are now less familiar with dosing these agents. Combining unfamiliarity with complex pharmacokinetic calculations, the risk of medication errors with aminoglycosides is extremely high. For these reasons, I have developed a new addition to ClinCalc — the aminoglycoside calculator. Continue reading
There is a significant amount of controversy regarding the most appropriate therapeutic goal for vancomycin therapy. The difference of opinion stems from the pharmacodynamic activity of vancomycin.
Ideal body weight and other body weight measures are widely used for a variety of medical purposes, including drug dosing, renal function, categorizing obesity, and dosing chemotherapy. The newest ClinCalc, the Ideal Body Weight Calculator, is capable of providing results and equations for the following body weight metrics:
Evaluating renal function for the purposes of drug dosing is a common task for clinical pharmacists, but a number of misconceptions have developed over the past forty years as the process of evaluating renal function has improved. The following are the top 10 facts that every clinician should know about creatinine clearance:
