Suggestion: When should it be available from 2014-2018

Rationale

Urine Chlamydia and gonorrhea DNA probes

2014 if not earlier Improves identification of STDs and minimizes empiric antibiotic use. Identifies high-risk activity and allows education of patient for risk reduction

C. diff toxin[correction:”antigen”] by GDH… in addition to toxin A/B ELISA testing.

2014 Touted by our microbiologist as well. Dual tests make detection more sensitive

C. diff PCR Specificity has been questioned though highly sensitive

CMV pp65 antigen testing

Whenever HSCT is up and running 2014?

Recommended test for CMV “preemptive” treatment program

Design a “CMV prevention program” on HSCT is up and running

Whenever HSCT is up and running 2014?

Whether we will be using the prophylactic route or preemptive treatment of CMV I n these patients

HSCT training Whenever HSCT is up and running 2014?

Would require a Paeds ID consultant if HSCT(allogeneic) takes place mostly in kids

HSV 1 and 2 viral culture medium ( very easily kept in refrig.)

2015 I think this could improve the cost benefit and allow diagnosing this I would suspect a prevalent dis in the immunocompromised

TB Gold test 2015 Probably better than Mantoux’ test in identifying prior exposure and hence possible current infection with TB when a dilemma in granulomatous inflammation that we so commonly encounter

Fixed dose once daily anti-retroviral agents

2014 or earlier Should be available readily from India if not from Malaysia, Thailand etc..Proven to improves patient adherence and hence outcome. Many of our cancer pts are also HIV infected.

Liposomal amphotericin B

2014 Really the way to go as far as treatment with ampho B to avoid renal toxicity which is much much less than regular ampho B

Isonaizid 300mg tabs! ( we only have the 100mg ones)

2014 Again a matter of adherence

INH-Rifampin combination(I don’t always use ethambutol additionally after the 2 initial months…. Esp with straight forward LYMPH NODE TB)

2014 Again a matter of adherence

Inactivated polio vaccine

Can consider If Paeds docs think it might be safer in the immunocompromised children and their family members

Rotavirus vaccine 2014 Would prevent diarrheal illnesses in the Neutropenic children and prevent nosocomial spread

Zoster vaccine for the elderly

2015 Zostavax is a live vaccine that has been shown to reduce the incidence of herpes zoster by 51.3% in a study of 38,000 adults aged 60 and older who received the vaccine

Typhoid vi polysaccharide vaccine

- I’m told we have this. Should we makes this mandatory in all employees? I see a lot of Salmonellosis in employees and their relatives