There are subtlties of antibiotic administration that must be considered: 1) While most centers mark start time at spiking the bag of the first broad spectrum antibiotic for infusion, the patient marks start time at infusion of a sufficient dose of antibiotic effective against the organism responsible for the clinical syndrome. Each center would benefit from looking at their in-house data to ensure administration of effective agents. Ceftriaxone is useless if the problem is MRSA pneumonia.
2) In real time one seldom knows the organism and which of 2 or 3 selected antibiotics will be effective. Many centers have implicit or explicit rules prohibiting rapid administration or simultaneous administration of 2 or more agents. This may be to better allow analysis of potential adverse side effects or allergic reactions. The patients, however, may be better served by disregarding these rules and rapidly administering agents simultaneously. As an alternative, at least we could be more vigilant about first giving the antibiotic effective against the most highly suspected organism. 3) It is interesting to note that some antibiotics result in more rapid killing and therefore faster release of endotoxin. I'm unaware of studies or data, but one might wonder if the price for faster killing might be a higher chance of early clinical deterioration. Thanks Ron Elkin, MD California Pacific Medical Center San Francisco On Sun, Sep 22, 2013 at 4:27 PM, Mary Draper <[email protected] > wrote: > We time it off of getting started. Infusion times can vary but start time > is easier to time off. > > Mary Draper RN BSN CCRN**** > Quality Manager-Best Practice Support**** > Quality Management Supervisor**** > Office (925) 674-2045**** > Cell (925) 451-8792**** > Fax (925) 674-2373**** > [email protected] > > > On Sep 22, 2013, at 3:32 PM, "Muhr, Lori" <[email protected]> wrote: > > I am wondering what everyone else is using for their antibiotic time. > Is it when it is initiated, while it is infusing, or after it is infused? > We had a lively discussion in our Sepsis meeting this week with each > Physician stating an argument for the different timeframes.**** > > ** ** > > I am looking to see what you are doing at your facility. Thanks**** > > ** ** > > ** ** > > ** ** > > ** ** > > Lori J. Muhr MSN, MHSM/MHA, APRN, ACNS-BC, CCRN, CEN**** > > Clinical Nurse Specialist - Clinical Coordinator – Sepsis**** > > Quality Services**** > > 817-702-1717**** > > [email protected]**** > > ** ** > > > > > > ------------------------------ > This electronic transmission and any attached files are intended solely > for the person or entity to which they are addressed and may contain > information that is privileged, confidential or otherwise protected from > disclosure under applicable law. Any review, retransmission, dissemination > or other use, including taking any action concerning this information by > anyone other than the named recipient, is strictly prohibited. If you are > not the intended recipient or have received this communication in error, > please immediately notify the sender by return email and delete the > original message from your system. > > _______________________________________________ > 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 > >
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