4 thoughts on “Gram Negative Coverage”

1. Adam, I noticed that they specifically made this for HC acquired infections. Can you ask how they defined that? Most often it’s something like admission/discharge from a hospital within 90 days, NH resident, etc. but it’s always good to be on the same page and make sure we’re using good abx stewardship for the ones who really need it.

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2. Michael, the ID society definitions for MDRO causing hospital/health-care acquired infection were utilized. These include: antimicrobial therapy in preceding 90 days, current hospitalization of 5 days or more, high frequency of antibiotic resistance in the community or
   in the specific hospital unit, hospitalization for 2 days or more in the preceding 90 days, residence in a nursing home or extended care facility, home infusion therapy (including antibiotics), dialysis within 30 days, home wound care, family member with MDRO, and immunosuppressive dz and/or therapy.

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3. Thanks for sharing Dr Ross! A wealth of useful knowledge can be gained from regularly consulting the local antibiogram. The susceptibilities that were quoted in the “Bugs and Drugs” article were from non-ICU isolates. Our ED patients (“Ambulatory Care” population) were 90% susceptible to pip/taz monotherapy and when adding a FQ, 95% susceptible. Pip/taz + tob = 99% susceptible. It’s good too see we still have better susceptibilities in our outpatient world, but if we want to keep that number elevated, we will need to continue to be (appropriately) judicial in our abx use. Also, pharmacy is currently updating our AMG use policy (spoiler alert: expect more extended-dosing AMG in our future, even for ortho prophy).

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4. What Chrissy said.

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