DoxyPEP STI guidance!
/Head on over to the Guidelines section for guidance on doxycycline prophylaxis for sexually transmitted diseases!
VA-GLA Infectious Diseases
Head on over to the Guidelines section for guidance on doxycycline prophylaxis for sexually transmitted diseases!
The GLA antibiogram for calendar year 2022 is here! Head on over to the “Susceptibilities” tab to check it out. Some highlights:
For Gram-negative rods in the hospital setting:
Carbapenem-resistant Enterobacterales remain relatively uncommon at GLA, but extended-spectrum beta-lactamase-producing Gram-negative rods are common in the nosocomial setting (example: 57% and 49% ceftriaxone susceptibility among nosocomial urinary and non-urinary E. coli, respectively).
Amikacin remains most active agent vs. multi-drug resistant Gram-negative rod infections at GLA.
If specific coverage for Pseudomonas is warranted, susceptibilities slightly favor piperacillin-tazobactam over cefepime and meropenem, 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.
For Gram-negative rods in the outpatient setting:
Cefazolin susceptibility among common urinary Enterobacterales 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 53% of nosocomial non-blood isolates, 76% of nosocomial blood isolates
MRSA ~40% outpatient non-blood isolates
Doxycycline susceptibility remains stable among non-blood outpatient S. aureus isolates (88%)
GLA COVID treatment protocols have been updated to reflect that EVUSHELD is no longer authorized for COVID prophylaxis in immunocompromised hosts. Head on over to the Guidelines section for the updated version.
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.