Download Guidelines for Antimicrobial Usage 2009-2010 by Cleveland Clinic PDF

By Cleveland Clinic

Presents concise suggestions on antimicrobial regimens for often encountered ailments within the sanatorium environment. directions constructed via a rigorous, multidiscipline method regarding the departments of infectious illness, medical pathology, pediatrics, and pharmacy on the Cleveland sanatorium.

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Live virus vaccines such as measles-mumps-rubella (MMR) are contraindicated in pregnancy with the exceptions of oral polio vaccine (OPV) and yellow fever virus vaccines. If indicated, inactivated vaccines, such as influenza and hepatitis B, can be administered to high-risk pregnant women. indd 53 53 9/30/2009 5:20:49 PM TABLE 24 Antimicrobials in Pregnancy Definitions of Pregnancy Category (continued) Category A: Controlled studies in women fail to demonstrate a risk to the fetus in the first trimester, and there is no evidence of a risk in later trimesters.

7 1400/200 mg q24h is not recommended in PI-experienced patients. 8 Only for treatment-naïve patients. 5 liters (48 ounces) of liquids per day is recommended. 5 3 5 7 9 11 Levels Peak and trough with third dose Peak and trough with third dose Peak and trough with third dose Peak and 24-hour random level; redose when random level is <2 mcg/mL (tobramycin/ gentamicin) or <8 mcg/mL (amikacin) Use actual body weight. 4 × (actual weight – ideal weight)] + ideal weight • Round dose to nearest 20 mg. indd 47 47 9/30/2009 5:20:48 PM TABLE 19 Traditional Aminoglycoside Dosing (continued) Serum Concentration Monitoring • Peak serum concentrations should be drawn 30 minutes after the completion of a 30-minute infusion.

The Primary Service must confirm PICC tip verification, and approve use of the PICC prior to discharge. Vascular Access Devices 1. Peripherally inserted central catheters (PICCs) are flexible long line catheters used for antibiotic infusions when therapy is planned for 2-8 weeks. 2. Midline catheters (20 cm long) are deep peripheral catheters used for short-term therapy. indd 56 56 9/30/2009 5:20:49 PM TABLE 26 Community-Based Parenteral Antibiotic Therapy (CoPAT) Guidelines (continued) Vascular Access Devices (continued) 3.

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