by Warren Joseph, DPM
Editor, Journal of the American Podiatric Medical Association

For years we have trusted Dr. Warren Joseph, the Editor of the Journal of the American Podiatric Medical Association, to bring us the most up to date information about antibiotics and infectious diseases.  His “Handbook of Lower Extremity Infections” has become required reading in the residency community. 

Dr. Joseph introduces us to six new antibiotics that have direct implications to podiatric practice.  His charismatic demeanor makes this voyage into the world of antibiotics entertaining. 

No matter what you have heard to the contrary, staphylococcus aureus and Group B streptococcus are still our greatest adversaries.  Dr. Joseph poses the question,  “Why are podiatrists still writing 11,000 prescriptions a month for Cipro?” a drug, with, at best poor coverage for staph and strep, particularly because Levaquin is a QD drug with better coverage.   He also raises the question , why would anyone use aminoglycocides when there are safer, more effective drugs available on the market today? 

Linezolid (Zyvox) is part of a new class of antibiotics (oxazolidinones).  It is effective against most gram (+) organisms, methicillin resistant staph aureus, vancomycin resistant enterococcus, and even vancomycin resistant staph aureus.  Despite it’s relative safety, many podiatrists are put off by its $1200.00 cost for a 10-day course.  Dr. Joseph asks us to compare this cost to a 10-day hospital stay with IV Vancomycin.  In reality, Zyvox is quite cost effective as compared to an inpatient stay. 

One of the Podiatry professions best friends is Medicis Pharmaceuticals.  Their third generation cephalosporin (Omnicef) has four to seven time better gram (+) coverage than cephalexin in a BID dose and good gram (-) coverage to boot.  Dr. Joseph feels it’s a good choice in more complex infections.  

The lecture gets you up to speed with all that is going on in the antibiotic world.  Thank you Dr. Joseph!!
 

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