Tuesday, March 21, 2017

Pneumococcal vaccine: Which, when, and why?

The pneumococcal vaccine was developed to reduce the disease burden of streptococcus pneumoniae, a gram-postive bacteria that has more than 90 serotypes that can cause diseases in humans.  Some of these infections include pneumonia, meningitis, bacteremia, otitis media, and sinusitis.  There are currently two vaccines on the market to raise immunity against pneumococcal infections - PCV13 (Prevnar 13 - which covers 13 serotypes) and PPSV23 (Pneumovax 23 - which covers 23 serotypes).  The 23-valent vaccine covers all of the serotypes in the

Tuesday, March 7, 2017

"How it works" series: Daptomycin

Daptomycin (Cubicin) is the first antibiotic in a class known as lipopeptides and has a unique mechanism of action.  Daptomycin is a large molecule with a high molecular weight and has two distinct sections.  One section is a 10 member amino acid ring (illustrated as the big red circle) and the other is the attached lipophilic tail (illustrated as the curvy red line).  The lipophilic tail is capable of direct insertion through the

Tuesday, February 7, 2017

Linezolid-induced thrombocytopenia

Thrombocytopenia is a notable adverse effect of linezolid.  Some of the evidence behind the onset, duration, and the extent of platelet decrease will briefly be described here and summarized in bullets at the bottom of the discussion.  For a discussion of linezolid's mechanism of action and some other notable features, see a prior post here.

Monday, January 16, 2017

Diabetes discharge checklist

A 55 year old business executive is being discharged from the hospital after a brief admission for cellulitis.  His only PMH is HTN and obesity.  During his stay, his casual serum glucoses were found to be in the high 200s mg/dL and a hemoglobin A1C resulted at 11.6%.  What should be done at the inpatient to outpatient transition to address his diabetes?

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