Practice-changing updates in the March 2020 release

The March 2020 release of eTG complete includes a new topic on coronavirus disease (COVID-19), with links to useful resources, and the following practice-changing updates to specific guidelines. With each release, we are also continuing to implement drug name changes in line with the Therapeutic Goods Administration.

Antibiotic guidelines

  • To help users navigate the sepsis topics, the categories applied in these guidelines to antibiotic regimens for sepsis or septic shock have been defined. A new table summarises the empirical regimens for sepsis or septic shock when the source of infection is not known. A list summarising the pathogen-specific regimens for bloodstream infections has also been added.
  • In the topic on ‘Pneumonia diagnosis and follow-up’, the statement on repeat chest X-ray has been reworded to clarify that a repeat chest X-ray is only recommended 6 to 8 weeks after the episode of pneumonia for patients in whom there is a clinical suspicion of lung malignancy (eg elderly, smokers).
  • The intravenous dose of trimethoprim+sulfamethoxazole for add-on empirical therapy for meningitis and encephalitis in patients with risk factors for Listeria infection, and for directed therapy of Listeria meningoencephalitis, has been updated to align with standard references.
  • The oral dose of trimethoprim+sulfamethoxazole for extended treatment of Listeria meningoencephalitis has been changed to a 12-hourly dosing schedule to improve patient adherence and avoid tablet splitting.
  • All trimethoprim+sulfamethoxazole 5+25 mg/kg doses for adults have been capped at 96 kg to avoid overdosing in obese patients. This equates to a maximum unit dose of 480+2400 mg.
  • Isavuconazole is now registered for use in Australia, so the footnote about availability through the Special Access Scheme has been deleted from the Aspergillosis section.

Dermatology guidelines

  • The time needed to store clothes, towels and bedding in a sealed plastic bag to prevent transmission of scabies has been increased to 8 days in line with new evidence.

Gastrointestinal guidelines

  • Table 6.22 (Oral 5-aminosalicylate preparations and dosages for ulcerative colitis) has been updated to reflect the change in criteria for accessing oral mesalazine on the Pharmaceutical Benefits Scheme (PBS)—for the treatment of ulcerative colitis, oral mesalazine is no longer reserved for patients with a documented history of a hypersensitivity reaction to a sulfonamide, or those intolerant to sulfasalazine.

Psychotropic guidelines