Hi all,

In the specification manual for nation hospital inpatient quality measures 
discharges 10-01-15 (4Q15) through 06-30-16 (2Q16)

"metronidazole is not represented on any table because it is not approved for 
monotherapy and if given, must be given with 2  other combination antibiotic 
therapy"

Just wondering why ceftriaxone or cefepime or  + metronidazole  will not 
surfice for treatment of intra abdominal infection?

What about patients with anaphylactic reaction to penicillin? I would recommend 
Aztreonam + metronidazole or  quinolone +metronidazole  for intra-abdominal 
source.

I don't understand why metronidazole has to be combine with 2 other combination 
antibiotics.

Please comment.

Thank you

Maria Osundele,Pharm D.CGP,BCPS
Clinical Pharmacy Coordinator
Orange Regional Medical Center
T:845-333-2036
C:845-649-1973
F:845-333-2029

[email protected]
ORMC PHARMACY: 'We chart the course to optimal pharmaceutical care for the 
safety and welfare of our patients'
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Encouraging Appropriate Antimicrobial Use

From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Kathleen Biederman
Sent: Tuesday, November 04, 2014 4:04 PM
To: '[email protected]'
Subject: [Sepsis Groups] blood culture while on IV antibiotics

Dear SSC,

What is the SSC guideline for whether to draw a blood culture on an inpatient 
who develops severe sepsis during the admission who has already been receiving 
broadspectrum IV antibiotic? This question is for both a first time BC and for 
a patient who had a BC done previously.  It is my understanding that when a 
patient develops new severe sepsis we are to follow the complete 3hour bundle 
regardless of whether he or she is already on IV antibiotics or whether a BC 
has been done already.

The repeat BC question came up during our case review today.  I see in a brief 
online lit review, ...BC repeats account for one-third of all BCs handled in 
the laboratory, with little additional yield. Guidelines for repeating BCs may 
decrease unnecessary testing." Clin Microbiol Infect 2004; 10: 624-627.  Are 
repeat blood cultures that are performed outside of the 3 hour bundle time not 
considered a fallout?

Thank you in advance for your guidance and any recommended references.


Regards,

Kathleen Biederman, RN, MS
Patient Quality & Safety Specialist

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