One of our VPs for Physician Services and a Pharmacy Clinical Coordinator have 
concerns about the antibiotic choices for the CMS requirements vs the IDSA 
guidelines in regards to intra-abdominal source of infection and UTI when there 
is a severe beta-lactam allergy.
One concern (intra-abd source) is that Flagyl must be given with 2 other 
antibiotics if given which could lead to a patient getting unnecessary 
antibiotics.  The second is, if the source of infection is urinary and most 
common pathogens are gram negative, Ciprofloxacin is not a "monotherapy" agent 
per CMS.  For IDSA, Linezolid and Daptomycin would not be encouraged to use for 
this scenario and other agents such as Clindamycin and macrolides are not used 
for urinary source of infection.  Does anyone have any clarification for this 
that I could bring back to my physicians and pharmacy coordinators?
Thank you!

Amy Cobb RN, BSN
Sepsis Coordinator/ICU Tracker
Research Outcomes
Morton Plant Hospital
MS #73
300 Pinellas St.
Clearwater, FL 33756
727-298-6953 (Desk)
727-462-3638 (Fax)
[email protected]<mailto:[email protected]>

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