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<title>RE: CARPA Digest, Vol 29, Issue 1</title>
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<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Sorry my error (before everyone rushes to
correct me), IV Vanc. Is on our Remote Doctors drug list<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Andrew<o:p></o:p></span></font></p>
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<p class=MsoNormal style='border:none;padding:0cm'><font size=2 color=navy
face=Arial><span style='font-size:10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
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<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Dear All<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>As far as I am aware vancomycin oral or IV
has never been on our Rural Health Essential Drug list and I am not aware of
any consideration of adding it. Agree with Malcolm.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Cheers<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<p class=MsoNormal><st1:PersonName w:st="on"><font size=2 color=navy
face=Arial><span style='font-size:10.0pt;font-family:Arial;color:navy'>Andrew
Bell</span></font></st1:PersonName><font size=2 color=navy face=Arial><span
style='font-size:10.0pt;font-family:Arial;color:navy'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
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<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'>
carpa-bounces@ozdocit.org [mailto:carpa-bounces@ozdocit.org] <b><span
style='font-weight:bold'>On Behalf Of </span></b>Malcolm McDonald<br>
<b><span style='font-weight:bold'>Sent:</span></b> Wednesday, 1 October 2008
2:09 PM<br>
<b><span style='font-weight:bold'>To:</span></b> carpa@ozdocit.org<br>
<b><span style='font-weight:bold'>Subject:</span></b> [CARPA] RE: CARPA Digest,
Vol 29, Issue 1</span></font><o:p></o:p></p>
</div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p><font size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:
Arial'>In reply to Julie Parras</span></font><o:p></o:p></p>
<p><font size=2 face=Symbol><span lang=EN-AU style='font-size:10.0pt;
font-family:Symbol'>·</span></font><font size=2 face="Courier New"><span
lang=EN-AU style='font-size:10.0pt;font-family:"Courier New"'> </span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>Clostridium difficile diarrhoea is</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>rare in the</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>NT</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>community</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>setting
- it is typically a hospital infection -</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>it
is</span></font><span lang=EN-AU> </span><font size=2 face=Arial><span
lang=EN-AU style='font-size:10.0pt;font-family:Arial'>also</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>uncommon</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>in</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>Northern and Central Australian hospitals</span></font><o:p></o:p></p>
<p><font size=2 face=Symbol><span lang=EN-AU style='font-size:10.0pt;
font-family:Symbol'>·</span></font><font size=2 face="Courier New"><span
lang=EN-AU style='font-size:10.0pt;font-family:"Courier New"'> </span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>The current Antibiotic Guidelines recommend
metronidazole for first line treatment of Clostridium difficile diarrhoea -
second line is oral Bacitracin capsules - third line</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>is oral vancomycin capsules</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>'only after consultation with</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>an infectious diseases</span></font><span lang=EN-AU>
</span><font size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;
font-family:Arial'>specialist</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>or</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>clinical microbiologist'. This would be</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>< 5 %</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>of
cases</span></font><span lang=EN-AU> </span><font size=2 face=Arial><span
lang=EN-AU style='font-size:10.0pt;font-family:Arial'>of an already</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>rare disease. </span></font><o:p></o:p></p>
<p><font size=2 face=Symbol><span lang=EN-AU style='font-size:10.0pt;
font-family:Symbol'>·</span></font><font size=2 face="Courier New"><span
lang=EN-AU style='font-size:10.0pt;font-family:"Courier New"'> </span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>Oral vancomycin is</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>NOT
an emergency drug - it can be</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>driven/flown
out to a community</span></font><span lang=EN-AU> </span><font size=2
face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>in the
extremely unlikely event that it would be needed</span></font><o:p></o:p></p>
<p><font size=2 face=Symbol><span lang=EN-AU style='font-size:10.0pt;
font-family:Symbol'>·</span></font><font size=2 face="Courier New"><span
lang=EN-AU style='font-size:10.0pt;font-family:"Courier New"'> </span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>People whose</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>Clostridium
difficile diarrhoea had not</span></font><span lang=EN-AU> </span><font size=2
face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>responded
to two courses of</span></font><span lang=EN-AU> </span><font size=2
face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>first
line therapy and a</span></font><span lang=EN-AU> </span><font size=2
face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>then</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>course of second line therapy</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>should</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>probably</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>be investigated in</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>hospital</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>anyway</span></font><span lang=EN-AU> </span><o:p></o:p></p>
<p><font size=2 face=Symbol><span lang=EN-AU style='font-size:10.0pt;
font-family:Symbol'>·</span></font><font size=2 face="Courier New"><span
lang=EN-AU style='font-size:10.0pt;font-family:"Courier New"'> </span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>There is a</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>sad</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>history of</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>inappropriate
use of</span></font><span lang=EN-AU> </span><font size=2 face=Arial><span
lang=EN-AU style='font-size:10.0pt;font-family:Arial'>vancomycin capsules</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>for</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>staphylococcal
infection in settings where</span></font><span lang=EN-AU> </span><font size=2
face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>doctors</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>and nurses</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>have
been</span></font><span lang=EN-AU> </span><font size=2 face=Arial><span
lang=EN-AU style='font-size:10.0pt;font-family:Arial'>unfamiliar with</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>the various</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>preparations
of</span></font><span lang=EN-AU> </span><font size=2 face=Arial><span
lang=EN-AU style='font-size:10.0pt;font-family:Arial'>the</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>drug (and</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>oral
vancomycin has been in stock). In other words it is potentially
dangerous. </span></font><span lang=EN-AU> </span><o:p></o:p></p>
<p><font size=2 face=Symbol><span lang=EN-AU style='font-size:10.0pt;
font-family:Symbol'>·</span></font><font size=2 face="Courier New"><span
lang=EN-AU style='font-size:10.0pt;font-family:"Courier New"'> </span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>The vast majority of</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>Australian</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>hospitals</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>forbid</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>the use of oral vancomycin capsules</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>in-house</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>unless</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>first approved</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>by</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>an infectious diseases</span></font><span lang=EN-AU>
</span><font size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;
font-family:Arial'>specialist</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>or</span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>clinical microbiologist - usually by telephone</span></font><span
lang=EN-AU> </span><o:p></o:p></p>
<p><font size=2 face=Symbol><span lang=EN-AU style='font-size:10.0pt;
font-family:Symbol'>·</span></font><font size=2 face="Courier New"><span
lang=EN-AU style='font-size:10.0pt;font-family:"Courier New"'> </span></font><span
lang=EN-AU> </span><font size=2 face=Arial><span lang=EN-AU style='font-size:
10.0pt;font-family:Arial'>Most</span></font><span lang=EN-AU> </span><font
size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:Arial'>health
professionals</span></font><span lang=EN-AU> </span><font size=2 face=Arial><span
lang=EN-AU style='font-size:10.0pt;font-family:Arial'>in remote communities
have access to a telephone</span></font><o:p></o:p></p>
<p><font size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:
Arial'>Best wishes</span></font><o:p></o:p></p>
<p><font size=2 face=Arial><span lang=EN-AU style='font-size:10.0pt;font-family:
Arial'>Malcolm</span></font><span lang=EN-AU> </span><o:p></o:p></p>
<p><font size=2 face="Courier New"><span style='font-size:10.0pt;font-family:
"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</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Send CARPA mailing list submissions to</span></font><o:p></o:p></p>
<p><font size=3 face="Times New Roman"><span lang=EN-AU style='font-size:12.0pt'>
</span></font><font size=2 face="Courier New"><span lang=EN-AU
style='font-size:10.0pt;font-family:"Courier New"'>carpa@ozdocit.org</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>To subscribe or unsubscribe via the World Wide Web,
visit</span></font><o:p></o:p></p>
<p><font size=3 face="Times New Roman"><span lang=EN-AU style='font-size:12.0pt'>
</span></font><font size=2 face="Courier New"><span lang=EN-AU
style='font-size:10.0pt;font-family:"Courier New"'><a
href="http://ozdocit.org/cgi-bin/mailman/listinfo/carpa">http://ozdocit.org/cgi-bin/mailman/listinfo/carpa</a></span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>or, via email, send a message with subject or body
'help' to</span></font><o:p></o:p></p>
<p><font size=3 face="Times New Roman"><span lang=EN-AU style='font-size:12.0pt'>
</span></font><font size=2 face="Courier New"><span lang=EN-AU
style='font-size:10.0pt;font-family:"Courier New"'>carpa-request@ozdocit.org</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>You can reach the person managing the list at</span></font><o:p></o:p></p>
<p><font size=3 face="Times New Roman"><span lang=EN-AU style='font-size:12.0pt'>
</span></font><font size=2 face="Courier New"><span lang=EN-AU
style='font-size:10.0pt;font-family:"Courier New"'>carpa-owner@ozdocit.org</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>When replying, please edit your Subject line so it
is more specific</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>than "Re: Contents of CARPA digest..."</span></font><o:p></o:p></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Today's Topics:</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'> 1. RE: CARPA Digest, Vol 28, Issue 1 -
Vancocin capsules </span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'> (Julie Parras)</span></font><o:p></o:p></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>----------------------------------------------------------------------</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Message: 1</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Date: Mon, 29 Sep 2008 11:00:13 +1000</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>From: "Julie Parras"
<julie.parras@aspenpharmacare.com.au></span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Subject: RE: [CARPA] CARPA Digest, Vol 28, Issue 1 -
Vancocin capsules</span></font><o:p></o:p></p>
<p><font size=3 face="Times New Roman"><span lang=EN-AU style='font-size:12.0pt'>
</span><o:p></o:p></font></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>To: "<st1:PersonName w:st="on">Central
Australian Rural Practitioners Association</st1:PersonName>"</span></font><o:p></o:p></p>
<p><font size=3 face="Times New Roman"><span lang=EN-AU style='font-size:12.0pt'>
</span></font><font size=2 face="Courier New"><span lang=EN-AU
style='font-size:10.0pt;font-family:"Courier New"'><carpa@ozdocit.org></span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Message-ID:</span></font><o:p></o:p></p>
<p><font size=3 face="Times New Roman"><span lang=EN-AU style='font-size:12.0pt'>
</span></font><font size=2 face="Courier New"><span lang=EN-AU
style='font-size:10.0pt;font-family:"Courier New"'><F79A83F5F064304790B801155F8D6884CEE1C0@aspensyd02.AspenDomain.local></span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Content-Type:
text/plain; charset="us-ascii"</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Dear Malcolm, interested in your comments below
regarding Vancomycin</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>capsules should not be made available in remote
communities, is this</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>because they would not have access to an infectious
disease specialist?</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Also wondered if patients in remote areas do need
Vancomycin capsules</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>how do they get treatment? Sent to area with specialist
or simply used</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>in last resort cases.</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>I look forward to your comments.</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Kind Regards</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'> </span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Julie Parras</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Senior Product Manager</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Aspen Pharmacare</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>PH: 61 2 8436 8300</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>FAX: 61 2 9901 3540</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'> </span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>-----Original Message-----</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>From: carpa-bounces@ozdocit.org [<a
href="mailto:carpa-bounces@ozdocit.org">mailto:carpa-bounces@ozdocit.org</a>]
On</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Behalf Of Malcolm McDonald</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Sent: Friday, 26 September 2008 3:21 PM</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>To: carpa@ozdocit.org</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Subject: [CARPA] CARPA Digest, Vol 28, Issue 1 -
Vancocin capsules </span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>It is important to emphasise that vancomycin
capsules are NEVER to be</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>used for treating staphylococcal infection -
vancomycin is not absorbed</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>from the gut. Vancomycin capsules are reserved for
third-line treatment</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>of Clostridium difficile diarrhoea following
consultation with an</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>infectious diseases specialist. </span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Vancomycin capsules should not be made available in
remote communities.</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Malcolm McDonald</span></font><o:p></o:p></p>
<p><st1:place w:st="on"><st1:PlaceName w:st="on"><font size=2 face="Courier New"><span
lang=EN-AU style='font-size:10.0pt;font-family:"Courier New"'>Menzies</span></font></st1:PlaceName><font
size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;font-family:
"Courier New"'> <st1:PlaceType w:st="on">School</st1:PlaceType></span></font></st1:place><font
size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;font-family:
"Courier New"'> of Health Research</span></font><o:p></o:p></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>-----Original Message-----</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>From: carpa-bounces@ozdocit.org [<a
href="mailto:carpa-bounces@ozdocit.org">mailto:carpa-bounces@ozdocit.org</a>]
On</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Behalf Of carpa-request@ozdocit.org</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Sent: Friday, September 26, 2008 11:30 AM</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>To: carpa@ozdocit.org</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Subject: CARPA Digest, Vol 28, Issue 1</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Send CARPA mailing list submissions to</span></font><o:p></o:p></p>
<p><font size=3 face="Times New Roman"><span lang=EN-AU style='font-size:12.0pt'>
</span></font><font size=2 face="Courier New"><span lang=EN-AU
style='font-size:10.0pt;font-family:"Courier New"'>carpa@ozdocit.org</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>To subscribe or unsubscribe via the World Wide Web,
visit</span></font><o:p></o:p></p>
<p><font size=3 face="Times New Roman"><span lang=EN-AU style='font-size:12.0pt'>
</span></font><font size=2 face="Courier New"><span lang=EN-AU
style='font-size:10.0pt;font-family:"Courier New"'><a
href="http://ozdocit.org/cgi-bin/mailman/listinfo/carpa">http://ozdocit.org/cgi-bin/mailman/listinfo/carpa</a></span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>or, via email, send a message with subject or body
'help' to</span></font><o:p></o:p></p>
<p><font size=3 face="Times New Roman"><span lang=EN-AU style='font-size:12.0pt'>
</span></font><font size=2 face="Courier New"><span lang=EN-AU
style='font-size:10.0pt;font-family:"Courier New"'>carpa-request@ozdocit.org</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>You can reach the person managing the list at</span></font><o:p></o:p></p>
<p><font size=3 face="Times New Roman"><span lang=EN-AU style='font-size:12.0pt'>
</span></font><font size=2 face="Courier New"><span lang=EN-AU
style='font-size:10.0pt;font-family:"Courier New"'>carpa-owner@ozdocit.org</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>When replying, please edit your Subject line so it
is more specific than</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>"Re: Contents of CARPA digest..."</span></font><o:p></o:p></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Today's Topics:</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'> 1. Vancocin Capsules now in Stock
(Julie Parras)</span></font><o:p></o:p></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>----------------------------------------------------------------------</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Message: 1</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Date: Thu, 25 Sep 2008 11:44:16 +1000</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>From: "Julie Parras"
<julie.parras@aspenpharmacare.com.au></span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Subject: [CARPA] Vancocin Capsules now in Stock</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>To: <carpa@ozdocit.org></span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Message-ID:</span></font><o:p></o:p></p>
<p><font size=3 face="Times New Roman"><span lang=EN-AU style='font-size:12.0pt'>
</span><o:p></o:p></font></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'><F79A83F5F064304790B801155F8D6884CEDF52@aspensyd02.AspenDomain.local></span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Content-Type: text/plain;
charset="us-ascii"</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Skipped content of type multipart/alternative--------------
next part</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>--------------</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>A non-text attachment was scrubbed...</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Name: CARPA letter codes vancocin Sept 08.doc</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Type: application/msword</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Size: 97792 bytes</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>Desc: CARPA letter codes vancocin Sept 08.doc Url :</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'><a
href="http://ozdocit.org/pipermail/carpa/attachments/20080925/507e42b4/CARPAle">http://ozdocit.org/pipermail/carpa/attachments/20080925/507e42b4/CARPAle</a></span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>ttercodesvancocinSept08-0001.doc</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>------------------------------</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>_______________________________________________</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>CARPA mailing list</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>CARPA@ozdocit.org</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'><a
href="http://ozdocit.org/cgi-bin/mailman/listinfo/carpa">http://ozdocit.org/cgi-bin/mailman/listinfo/carpa</a></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>End of CARPA Digest, Vol 28, Issue 1</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>************************************</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>--</span></font><o:p></o:p></p>
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font-family:"Courier New"'>This message was scanned by ESVA and is believed to
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<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>_______________________________________________</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>CARPA mailing list</span></font><o:p></o:p></p>
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font-family:"Courier New"'>CARPA@ozdocit.org</span></font><o:p></o:p></p>
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<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>------------------------------</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>_______________________________________________</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>CARPA mailing list</span></font><o:p></o:p></p>
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font-family:"Courier New"'>CARPA@ozdocit.org</span></font><o:p></o:p></p>
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font-family:"Courier New"'><a
href="http://ozdocit.org/cgi-bin/mailman/listinfo/carpa">http://ozdocit.org/cgi-bin/mailman/listinfo/carpa</a></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>End of CARPA Digest, Vol 29, Issue 1</span></font><o:p></o:p></p>
<p><font size=2 face="Courier New"><span lang=EN-AU style='font-size:10.0pt;
font-family:"Courier New"'>************************************</span></font><o:p></o:p></p>
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font-family:"Courier New"'>--</span></font><o:p></o:p></p>
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