Survey of physician knowledge regarding antiretroviral medications in hospitalized HIV-infected patients

<p>Abstract</p> <p>Background</p> <p>Antiretroviral prescribing errors are common among hospitalized patients. Inadequate medical knowledge is likely one of the factors leading to these errors. Our objective was to determine the proportion of hospital physicians with knowledge gaps about prescribing antiretroviral medications for hospitalized HIV-infected patients and to correlate knowledge with length and type of medical training and experience.</p> <p>Methods</p> <p>We conducted an electronic survey comprising of ten clinical scenarios based on antiretroviral-prescribing errors seen at two community teaching hospitals. It also contained demographic questions regarding length and type of medical training and antiretroviral prescribing experience. Three hundred and forty three physicians at both hospitals were asked to anonymously complete the survey between February 2007 and April 2007.</p> <p>Results</p> <p>One hundred and fifty-seven physicians (46%) completed at least one question. The mean percentage of correct responses was 33% for resident physicians, 37% for attending physicians, and 93% for Infectious Diseases or HIV (ID/HIV) specialist physicians. Higher scores were independently associated with ID/HIV specialty, number of outpatients seen per month and physician reported comfort level in managing HIV patients (P < .001).</p> <p>Conclusion</p> <p>Non-ID/HIV physicians had uniformly poor knowledge of common antiretroviral medication regimens. Involvement of ID/HIV specialists in the prescribing of antiretrovirals in hospitalized patients might mitigate prescribing errors stemming from knowledge deficits.</p

Subacute onset of paralysis in a person with AIDS

We report a case of subacute onset of paraparesis in a patient with AIDS. Empiric treatment for toxoplasmosis of the brain and the spinal cord resulted in resolution of the paraparesis. This case highlights the differential diagnosis of toxoplasmosis of the spinal cord and reviews its management in HIV-infected patients