* For use of metronidazole in a patient with intraabdominal infection and severe beta-lactam allergy, CMS states it must be given with two other combination therapy drugs- one for gram-negatives (aminoglycoside, cipro, aztreonam) and one for gram-positives (likely vancomycin)
* CMS designates ciprofloxacin as a narrow spectrum/combination agent as you indicated. I think the easiest way around this would be to use levofloxacin rather than ciprofloxacin, as levofloxacin is considered a "monotherapy" drug by CMS. Steven C Ebert, PharmD Clinical Manager, Infectious Diseases Department of Pharmacy, Meriter UnityPoint Health Hospital 202 S. Park Street Madison, WI 53715 (608)-417-6035 (Office) (608)-417-6022 (Fax) (608)-628-6081 (Mobile) Note: my hospital email has changed to [email protected]<mailto:[email protected]> Please update my contact information. Message: 1 Date: Wed, 30 Dec 2015 20:31:06 +0000 From: "Cobb, Amy L." <[email protected]<mailto:[email protected]>> To: "[email protected]<mailto:[email protected]>" <[email protected]<mailto:[email protected]>> Subject: [Sepsis Groups] Physician concerns over IDSA guidelines for antibiotics vs CMS requirements 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]<mailto:[email protected]%3cmailto:[email protected]>> This message and accompanying documents are covered by the Electronic Communications Privacy Act, 18 U.S.C. SSSS 2510-2521, and contain information intended for the specified individual(s) only. This information is confidential. If you are not the intended recipient or an agent responsible for delivering it to the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, copying, or the taking of any action based on the contents of this information is strictly prohibited. If you have received this communication in error, please notify us immediately by e-mail, and delete the original message.
HIQR Manual Oct 2015- ABX Tables.pdf
Description: HIQR Manual Oct 2015- ABX Tables.pdf
HIQR Manual Oct 2015- Pharmacy Elements.pdf
Description: HIQR Manual Oct 2015- Pharmacy Elements.pdf
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