Hello All !
We have use
Piperacillin, Meropenem, Doripenem in continues infusion, in the case of
meropenem we use 1 gr in saline solution for 6 hours, every 8 hours,
piperacillin 4.5grs for 4 hours every 6 or 8 hours depents.We see a good
results in all cases, the problem will be the clostfridium dificile infection
or candida.
but even we recomendet
Dr. Adrian VerdinCritical CareChihuahua, Chih, Mexico+52 614 159-3883
From: [email protected]
To: [email protected]; [email protected]
Date: Thu, 7 Jun 2012 14:55:00 +0000
Subject: Re: [Sepsis Groups] Extended Infusion Beta Lactam Antibiotics
While we are not currently doing this, we do have plans to start. Please see
comments from our Infectious Disease Clinical Pharmacist below…
Thanks,
Steve
Steve Klahn, MBA, RN, CCRN
eICU Operations Director
Baptist Health System- San Antonio, TX
(210) 297-2390
Prolonged Infusion ( 3-4 hours) of beta-lactams has shown superiority over
standard infusion times of 30-60min. This is based on the way beta-lactams
kill (Pharmacodynamics "PD").
Beta-lactams kill by maintaining concentrations above the MIC of the organism
and not by achieving high Peak concentrations and letting the levels drift down
below the MIC.
Continuous Infusion produces the same PD effect, but it occupies a line for
24hrs where the Prolonged Infusion only takes up a port for a few hours.
The efficacy of this type of dosing has been clearly demonstrated with
Piperacillin, Meropenem, Doripenem, Nafcillin and Cefepime. Not all
beta-lactams can be dosed this way due
to short stability or need to be dosed this way due to high protein binding.
Non-beta-lactams like Vancomycin have shown superiority, when given by
continuous infusion vs standard infusion times, especially for Meningitis.
The plan is to take the prolonged infusion of Zosyn, Cefepime and Meropenem to
MEC and request for all patients with ClCr>30ml/min, that Pharmacy be given
automatic substitution
authority to change the infusion times. Zosyn will go to Zosyn 3.375gm IV
Q8hrs infused over 4 hours, instead of Q6hrs. Meropenem will be 1gm IV Q8 or
12hrs infused over 4 hours and Cefepime will go to Q8 or 12hrs infused over 3
hours. So no reduction
in Meropenem or Cefepime doses or interval, just extension of infusion time.
Jaye
From:
[email protected]
[mailto:[email protected]]
On Behalf Of Shawver, Stephanie
Sent: Friday, June 01, 2012 4:55 PM
To: [email protected]
Subject: [Sepsis Groups] Extended Infusion Beta Lactam Antibiotics
Colleagues,
I am curious to hear feedback on the recent studies indicating that extended or
continuous infusion of certain beta-lactam antibiotics have shown better
outcomes for severe sepsis and septic shock patients. Our
hospital’s Sepsis Committee is considering changing the antibiotic regime on
our protocol to have the applicable beta-lactam antibiotics infused over an
extended period of time, if not continuous. Are there any other facilities out
there going this route?
Stephanie Shawver BSN, RN
Infection Prevention Practitioner & SLMV Sepsis Coordinator
St. Luke's Magic Valley
801 Pole Line Road West | Twin Falls, ID 83301
Office: (208) 814.3052 | Email:
[email protected]
Infection Prevention Line: (208)-814-5120
“ We are what we repeatedly do. Excellence then, is not an act but a habit.” -
Aristotle
mg.slrmc.org made the following annotations
---------------------------------------------------------------------
"This message is intended for the use of the person or entity to which it is
addressed and may contain information that is confidential or privileged, the
disclosure of which is governed by applicable law. If the reader of this
message
is not the intended recipient, you are hereby notified that any dissemination,
distribution, or copying of this information is strictly prohibited. If you
have
received this message by error, please notify us immediately and destroy
the related message."
---------------------------------------------------------------------
------------------------
This message (including any attachments) is confidential and intended
solely for the use of the individual or entity to whom i
This message (including any attachments) is confidential and
intended solely for the use of the individual or entity to whom it is
addressed, and is protected by law. If
you are not the intended recipient, please delete the message (including any
attachments) and notify the originator that you received the message in
error. Any disclosure, copying, or
distribution of this message, or the taking of any action based on it, is
strictly prohibited. Any views
expressed in this message are those of the individual sender, except where the
sender specifies and with authority, states them to be the views of Vanguard
Health Systems.
_______________________________________________
Sepsisgroups mailing list
[email protected]
http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
_______________________________________________
Sepsisgroups mailing list
[email protected]
http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
