new HIV pre-exposure prophylaxis guidance!
/New local guidance for HIV pre-exposure prophylaxis (including when to consider cabotegravir) is now available in the “Guidelines” section!
VA-GLA Infectious Diseases
New local guidance for HIV pre-exposure prophylaxis (including when to consider cabotegravir) is now available in the “Guidelines” section!
New GLA COVID treatment guidelines are posted in the “Guidelines” section that reflect deauthorization of bebtelovimab and weighing evidence of benefit of Evusheld vs. circulating variants.
The old antimicrobial approval pager has been retired! The new antimicrobial approval phone number is 323-891-5282. Can call or text during regular business hours.
New monkeypox guidance is now available under the “Guidelines” tab. More to follow!
The GLA antibiogram for calendar year 2021 is here! Some highlights:
For Gram-negative rods in the hospital setting:
Carbapenem-resistant Enterobacteriaceae remain relatively uncommon at GLA
Amikacin remains most active agent vs. multi-drug resistant Gram-negative rod infections at GLA, despite P. aeruginosa susceptibility decreasing somewhat (2020: 100%; 2021: 92%)
If specific coverage for Pseudomonas is warranted, piperacillin-tazobactam provides more coverage (87%) than cefepime (61%) and meropenem (61%), though meropenem and ertapenem have better coverage against non-Pseudomonas Gram-negative nosocomial isolates
Fluoroquinolone susceptibility versus most nosocomial Gram-negative organisms remains relatively poor and ceftriaxone susceptibility among urine nosocomial Gram-negatives is variable.
For Gram-negative rods in the outpatient setting:
Cefazolin susceptibility among common urinary Enterobacteriaceae is not readily captured but susceptibility rates among other beta-lactams remain relatively stable
Fluoroquinolone and TMP-SMX susceptibilities remain largely stable
Key trends among Gram-positive isolates:
MRSA 56% of nosocomial non-blood isolates, 47% of nosocomial blood isolates
MRSA ~40% outpatient non-blood isolates
Doxycycline susceptibility remains stable among non-blood S. aureus isolates (83% nosocomial, 90% outpatient)