Title: Re: vancomycin
We you at INS in Reno or AVA in Indy this year? I gave a presentation on pathophysiology of 4 common complications, phlebitis was one. Here is the list of references:

1.      Cheek D, Smith HM, Good J. New respect for the humble endothelium. Nursing2006. 2006;36(3):44-47.
2.
     Palefski S, Stoddard G. The infusion nurse and patient complication rates of peripheral-short catheters: A prospective evaluation. Journal of Intravenous Nursing. 2001;24(2):113-123.
3.
        Maki DG, Ringer M. Risk factors for infusion-related phlebitis with small peripheral venous catheters. Annals of Internal Medicine. 1991;114:845-854.
4.
Kuwahara T, Asanami S, Kubo S. Experimental infusion phlebitis: Tolerance osmolality of peripheral venous endothelial cells. Nutrition. 1998;14(6):496-501.
5.
   Kuwahara T, Asanami S, Tamura T, Kubo S. Dilution is effective in reducing infusion phlebitis in peripheral parenteral nutrition: An experimental study in rabbits. Nutrition. 1998;14(2):186-190.
6.
    Stranz M. Adjusting pH and osmolarity levels to fit standards and practices. Journal of Vascular Access Devices. 2002;7(3):12-18.
7.
     Robibaro B, Vorbach H, Weigel G, et al. Endothelial cell compatibility of glycopeptide antibiotics for intravenous use. Journal of Antimicrobial Chemotherapy. 1998;41(297-300).
8.
      Armbruster C, Robibaro B, Griesmacher A, Vorbach H. Endothelial cell compatibility of trovafloxacin and levofloxacin for intravenous use. Journal of Antimicrobial Chemotherapy. 2000;45:533-535.
9.
     Vorbach H, Armbruster C, Robibaro B, Griesmacher A. Endothelial cell compatibility of azithromycin and erythromycin. Journal of Antimicrobial Chemotherapy. 2002;49:407-409.
10.
Lanbeck P, Odenholt I, Riesbeck K. Dicloxacillin and erythromycin at high concentrations increase ICAM-1 _expression_ by endothelial cells: A possible factor in the pathogenesis of infusion phlebitis. Journal of Antimicrobial Chemotherapy. 2004;53(2):174-179.
11.
    Tagalakis V, Kahn S, Libman M, Blostein M. The epidemiology of peripheral vein infusion thrombophlebitis: A critical review. American Journal of Medicine. 2002;113:146-151.
12.
Kagel E, Rayan G. Intravenous catheter complications in the hand and forearm. Journal of Trauma. 2004;56:123-127.
13.
    Schears G. Summary of product trials for 10,164 patients: Comparing an intravenous stabilizing device to tape. Journal of Infusion Nursing. 2006;29(4):225-231.
Bottom line is that is evidence from animal studies that drug pH of 4.5 causes severe phlebitis in 100% of cases using veins from rabbit ears.

Now there is also evidence that chemical phlebitis is real. Human umbilical veins are used to harvest endothelial cells, cultured in a lab, then challenged with various antibiotics, then cellular products of inflammation were measured. Many antibiotics, including vanco, produce these inflammatory chemicals.

Hope this helps, Lynn

At 5:37 AM -0700 10/27/06, DS BROADHURST wrote:
We are presently in dialogue with pharmacy re central administration of vancomycin and are looking for more evidence to support this. Lynn, we have your 3 articles (thank you!); however pharmacy is requesting further published references. I know many of the esteemed nurses on this list serve have been instrumental in implementing this in your facilities. Would love to know what evidence you presented to facilitate this. If your pharmacy has a parenteral drug manual in which administration of Vanco via CVAD is recommended (or any another reference), could you kindly email or fax a copy to me.
Many thanks,
Daphne Broadhurst, RN
Ottawa ON
fax 613-739-6641


-- 
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861



  • vancomycin DS BROADHURST
    • Re: vancomycin Lynn Hadaway

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