The organism was not sensitive to amoxicillin, and the pt still had a
fever; that is why i changed to keflex (which it was sensitive to).
There, perfect spelling, no abbreviations and clinically sensible.
Puntuation suspect... Why do you use contact lenses to read?/
On Dec 19, 2007, at 4:52 PM, Doc Holiday wrote:
> From: [log in to unmask]
>> Any critique of me
> --> YES!!!
> Write in ENGLISH!!!
> I lost 3 contact lenses trying to work out what half the stuff you
> used here insetad of "words". Forgive me for so severly demoting
> that literary entity by using it even in comparison with
> abominations such as "b9" and "+nit" and "mssa"...
> Not to worry - only kidding. Managed to work them all out and had a
> good laugh along the way...
> But forgive me, please, if I have misunderstood what you say after
> Patient seems to have a UTI... But is active and playing (although
> with a raised temperature)
> Urine growing Staph which is sensitive to Methicillin...
> Patient has had 24 hours' worth of amoxicillin...
> And you change it at that point to BOTH rocephin AND keflex.
> Now these are lovely antibiotics and all that, but I am curious as
> to what sort of urine culture result would have made you give the
> amoxicillin & fever the chance to work? Seems to me that if finding
> that a patient who is on amoxicillin DOES indeed have a sensitive
> organism still does not convince us to let that antibiotic have a
> "go", then amoxil should be declared as something which people
> should NOT be giving out to patients with UTI at all. I would be
> quite happy to have this put on paper - "do not use amoxicillin for
> UTI" - as I do not think it has a good enough chance to be used
> empirically with resistance levels as they are, but in this case we
> SEEM to have got lucky...
>> I saw one of these yesterday. 3 yo with fever for 4 days. only
>> complaint was mild abd pain. seen 3d b4 and other doc got cbc, chem
>> 7, and urine. exam was b9. wbc=24k. urine with +trace nitrate and 4
>> wbc/hpf. sent home with no abx. came back the day b4 i saw her, and
>> repeated wbc=12 and got strep screen altho throat exam said normal
>> and it was + (although also + in oct). started on amox. came back
>> yesterday and i saw her. extremely adorable and pleasant and
>> playful active who"kept mom up all not" treating the fever. the
>> temp was 102.9. all ohter vitals normal. urine now groing staph
>> aureus 25-50k that is mssa. was a cath spec. repeat urine with 4wbc
>> and +nit. I switched to keflex and gave shot of rocephin.
> Any critique of me (or others- i would critique others).
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Donald Zweig MD
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