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<TITLE>RE: CARPA Digest, Vol 29, Issue 1</TITLE>
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<P DIR=LTR><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">In reply to Julie Parras</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Symbol">·<FONT FACE="Courier New"> </FONT></FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">Clostridium diffic</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">ile diarrhoea is</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">r</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">are in the</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">NT</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">community</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">setting</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> - it is typically a hospital infection -</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">it is</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">a</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">lso</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">uncommon</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">in</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">N</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">orthern and Central Australia</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">n hospitals</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Symbol">·<FONT FACE="Courier New"> </FONT></FONT></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">The current Antibiotic Guidelines recommend metronidaz</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">o</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">le for first line</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> treatment of C</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">lostridium difficile diarrhoea</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> - second line is oral Bacitracin capsules - third line</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">is</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> oral vancomycin capsules</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">'only after consultation with</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">an</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> infectious diseases</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">specialist</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"></FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">or</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">clinical</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> microbiologist</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">'. T</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">his would be</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">< 5 %</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">of cases</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">of a</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">n already</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">rare disease</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">.</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Symbol">·<FONT FACE="Courier New"> </FONT></FONT></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">Oral vancomycin is</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">NOT</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> an emergency drug - it can be</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">driven/</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">flown out to a community</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">in the extremely unlikely event that it would be needed</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Symbol">·<FONT FACE="Courier New"> </FONT></FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">P</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">eople whose</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">Clostridium diffic</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">ile diarrhoea</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> ha</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">d</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> not</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">responded</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> to two courses of</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">first</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> line therapy and a</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">then</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">course of second line therapy</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">should</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">probably</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">be investigated in</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">hospital</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"></FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">anyway</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"></FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> </SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Symbol">·<FONT FACE="Courier New"> </FONT></FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">There is a</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">sad</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">history</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> of</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">inappropriate use of</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">vancomycin capsules</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">for</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">s</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">taphylococcal</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> infection in setting</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">s</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> where</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">doctors</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">and nurses</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">have been</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">un</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">familiar with</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">the various</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">preparations</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> of</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">the</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">drug (</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">and</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">oral vancomycin has been in stock)</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">. In other words it is potentially dangerous</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">.</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> </FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial"></FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> </SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Symbol">·<FONT FACE="Courier New"> </FONT></FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">The vast majority of</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"></FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">Australia</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">n</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"></FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">hospital</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">s</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"></FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">forbid</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">the use of oral vancomycin capsule</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">s</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"></FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">in-house</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">unless</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">first approved</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"></FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">by</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">an</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> infectious diseases</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">specialist</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"></FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">or</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">clinical</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> microbiologist</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial"> - usually by telephone</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> </SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"><FONT SIZE=2 FACE="Symbol">·<FONT FACE="Courier New"> </FONT></FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">Most</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">health professionals</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Arial">in remote communities have access to a telephone</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">Best wishes</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Arial">Malcolm</FONT></SPAN><SPAN LANG="en-au"></SPAN><SPAN LANG="en-au"> </SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"></SPAN><SPAN LANG="en-us"><FONT SIZE=2 FACE="Courier New">-----Original Message-----<BR>
From: carpa-bounces@ozdocit.org [<A HREF="mailto:carpa-bounces@ozdocit.org">mailto:carpa-bounces@ozdocit.org</A>] On Behalf Of carpa-request@ozdocit.org<BR>
Sent: Wednesday, October 01, 2008 11:30 AM<BR>
To: carpa@ozdocit.org<BR>
Subject: CARPA Digest, Vol 29, Issue 1</FONT></SPAN><SPAN LANG="en-au"></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Send CARPA mailing list submissions to</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Courier New">carpa@ozdocit.org</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">To subscribe or unsubscribe via the World Wide Web, visit</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Courier New"><A HREF="http://ozdocit.org/cgi-bin/mailman/listinfo/carpa">http://ozdocit.org/cgi-bin/mailman/listinfo/carpa</A></FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">or, via email, send a message with subject or body 'help' to</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Courier New">carpa-request@ozdocit.org</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">You can reach the person managing the list at</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Courier New">carpa-owner@ozdocit.org</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">When replying, please edit your Subject line so it is more specific</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">than "Re: Contents of CARPA digest..."</FONT></SPAN></P>
<BR>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Today's Topics:</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New"> 1. RE: CARPA Digest, Vol 28, Issue 1 - Vancocin capsules </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New"> (Julie Parras)</FONT></SPAN></P>
<BR>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">----------------------------------------------------------------------</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Message: 1</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Date: Mon, 29 Sep 2008 11:00:13 +1000</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">From: "Julie Parras" <julie.parras@aspenpharmacare.com.au></FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Subject: RE: [CARPA] CARPA Digest, Vol 28, Issue 1 - Vancocin capsules</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"> </SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">To: "Central Australian Rural Practitioners Association"</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Courier New"><carpa@ozdocit.org></FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Message-ID:</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Courier New"><F79A83F5F064304790B801155F8D6884CEE1C0@aspensyd02.AspenDomain.local></FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Content-Type: text/plain; charset="us-ascii"</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Dear Malcolm, interested in your comments below regarding Vancomycin</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">capsules should not be made available in remote communities, is this</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">because they would not have access to an infectious disease specialist?</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Also wondered if patients in remote areas do need Vancomycin capsules</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">how do they get treatment? Sent to area with specialist or simply used</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">in last resort cases.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">I look forward to your comments.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Kind Regards</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New"> </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Julie Parras</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Senior Product Manager</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Aspen Pharmacare</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">PH: 61 2 8436 8300</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">FAX: 61 2 9901 3540</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New"> </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">-----Original Message-----</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">From: carpa-bounces@ozdocit.org [<A HREF="mailto:carpa-bounces@ozdocit.org">mailto:carpa-bounces@ozdocit.org</A>] On</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Behalf Of Malcolm McDonald</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Sent: Friday, 26 September 2008 3:21 PM</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">To: carpa@ozdocit.org</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Subject: [CARPA] CARPA Digest, Vol 28, Issue 1 - Vancocin capsules </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">It is important to emphasise that vancomycin capsules are NEVER to be</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">used for treating staphylococcal infection - vancomycin is not absorbed</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">from the gut. Vancomycin capsules are reserved for third-line treatment</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">of Clostridium difficile diarrhoea following consultation with an</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">infectious diseases specialist. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Vancomycin capsules should not be made available in remote communities.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Malcolm McDonald</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Menzies School of Health Research</FONT></SPAN></P>
<BR>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">-----Original Message-----</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">From: carpa-bounces@ozdocit.org [<A HREF="mailto:carpa-bounces@ozdocit.org">mailto:carpa-bounces@ozdocit.org</A>] On</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Behalf Of carpa-request@ozdocit.org</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Sent: Friday, September 26, 2008 11:30 AM</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">To: carpa@ozdocit.org</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Subject: CARPA Digest, Vol 28, Issue 1</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Send CARPA mailing list submissions to</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Courier New">carpa@ozdocit.org</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">To subscribe or unsubscribe via the World Wide Web, visit</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Courier New"><A HREF="http://ozdocit.org/cgi-bin/mailman/listinfo/carpa">http://ozdocit.org/cgi-bin/mailman/listinfo/carpa</A></FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">or, via email, send a message with subject or body 'help' to</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Courier New">carpa-request@ozdocit.org</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">You can reach the person managing the list at</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"> <FONT SIZE=2 FACE="Courier New">carpa-owner@ozdocit.org</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">When replying, please edit your Subject line so it is more specific than</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">"Re: Contents of CARPA digest..."</FONT></SPAN></P>
<BR>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Today's Topics:</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New"> 1. Vancocin Capsules now in Stock (Julie Parras)</FONT></SPAN></P>
<BR>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">----------------------------------------------------------------------</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Message: 1</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Date: Thu, 25 Sep 2008 11:44:16 +1000</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">From: "Julie Parras" <julie.parras@aspenpharmacare.com.au></FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Subject: [CARPA] Vancocin Capsules now in Stock</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">To: <carpa@ozdocit.org></FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Message-ID:</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"> </SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New"><F79A83F5F064304790B801155F8D6884CEDF52@aspensyd02.AspenDomain.local></FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Content-Type: text/plain; charset="us-ascii"</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Skipped content of type multipart/alternative-------------- next part</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">--------------</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">A non-text attachment was scrubbed...</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Name: CARPA letter codes vancocin Sept 08.doc</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Type: application/msword</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Size: 97792 bytes</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">Desc: CARPA letter codes vancocin Sept 08.doc Url :</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New"><A HREF="http://ozdocit.org/pipermail/carpa/attachments/20080925/507e42b4/CARPAle">http://ozdocit.org/pipermail/carpa/attachments/20080925/507e42b4/CARPAle</A></FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">ttercodesvancocinSept08-0001.doc</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">------------------------------</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">_______________________________________________</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">CARPA mailing list</FONT></SPAN></P>
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<BR>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">End of CARPA Digest, Vol 28, Issue 1</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">************************************</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">--</FONT></SPAN></P>
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<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">_______________________________________________</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">CARPA mailing list</FONT></SPAN></P>
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<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">------------------------------</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">_______________________________________________</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">CARPA mailing list</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">CARPA@ozdocit.org</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New"><A HREF="http://ozdocit.org/cgi-bin/mailman/listinfo/carpa">http://ozdocit.org/cgi-bin/mailman/listinfo/carpa</A></FONT></SPAN></P>
<BR>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">End of CARPA Digest, Vol 29, Issue 1</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">************************************</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-au"><FONT SIZE=2 FACE="Courier New">--</FONT></SPAN></P>
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