Osteomyelitis Management

Management

Follow Up

Response to treatment is evaluated through clinical (ie symptom resolution) & lab parameters
- Erythrocyte sedimentation rate (ESR) levels usually reach peak levels 3-5 days after the start of treatment & return to normal in about 2 wk
- C-reactive protein (CRP) levels peak 2 days after the start of treatment & return to normal after about 1 wk

Antibiotic therapy should be revised based on results of culture & sensitivity studies
If cultures are sterile & symptoms are resolving, empiric antibiotic therapy should be continued
Assess patient’s need to be enrolled in a community-based parenteral anti-infective therapy program
- A functioning outpatient parenteral antimicrobial therapy (OPAT) program should have a complete & qualified health care team, efficient means of communication, guidelines for follow-up, testing & other interventions, written policies & procedures & outcomes monitoring
- A candidate for inclusion in an outpatient parenteral antimicrobial therapy (OPAT) program should be willing to participate in the program & should have a home environment that is sufficient to support care

Burden of Dengue amidst the COVID-19 Pandemic

12 Jul 2022

Dengue fever (DF) is endemic in many tropical countries, including Singapore, and is spread by Aedes mosquitoes. All four serotypes of the dengue virus (DENV 1–4) are found in Singapore, with serotype distribution fluctuating from year to year. DENV-1 and DENV-2 were previously the dominant serotypes in outbreaks, but DENV-3 has now replaced DENV-2 as the most common serotype in 2022. Along with a larger proportion of people staying home due to the COVID-19 pandemic, this has resulted in an increase in dengue incidence in Singapore. In the week of 12th to 18th June 2022, 1,258 new dengue cases were reported. According to the National Environment Agency (NEA), this number is expected to rise and exceed the highest weekly figure of 1,787 cases recorded in 2020.

Spotlight on multidrug-resistant gram-negative infections: New developments for an old problem

Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021

Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.

Rapid antigen test: Don’t let perfect be the enemy of good

Pearl Toh, 23 Oct 2021

While rapid antigen test is less sensitive than conventional nucleic acid amplification test (NAAT) such as RT-PCR* in detecting SARS-CoV-2 virus, “a test does not have to be perfect to be clinically useful,” said Professor Angela Caliendo during a session in IDWeek 2021 — echoing the maxim that perfect should not be the enemy of good in the pandemic era.