DOCSLIB.ORG

Surgical Prophylaxis Antibiotic Recommendations Updated 2017

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Surgical Prophylaxis Antibiotic Recommendations Updated 2017 Surgical Prophylaxis Antibiotic Recommendations Updated 2017 1. Prophylactic antibiotic is to be initiated within 1 hour prior to incision Exception: Due to the longer infusion time required, initiate vancomycin and ciprofloxacin within 2 hours prior to incision 2. Anesthesia to give preoperative antibiotic dose and document time on anesthesia record. Exception: Antibiotics in Endoscopy, Labor and Delivery and Birth Care Center 3. Chose alternative antibiotic if patient is allergic to recommended first line antibiotic. Avoid giving cefazolin or cefotetan if the patient has allergies to cephalosporins or a life- threatening allergy to penicillin (angioedema, bronchoconstriction, cardiac arrhythmias, hypotension, or respiratory distress) 4. Pediatric Patients: Maximum dose is dose listed for wt <80 kg. For pediatric patients >80 kg, follow adult dosing. 5. For patients colonized with MRSA: Give vancomycin as the pre-op antibiotics for cardiac, vascular, orthopedic, neurological, and head and neck surgeries. For all other surgeries, give vancomycin in addition to the antibiotics listed below. To determine if a patient is colonized with MRSA, please see flow sheet below. 6. Per Clinical Practice Restricted/High Risk Medications with Special Requirements Policy: Pre-operative antibiotics for prophylaxis in adult patients will be automatically substituted to the antibiotics listed on Adult Surgical Pre-Operative Antibiotic Prophylaxis order set #347. For surgeries/procedures not addressed on the order set, anesthesia is to discuss antibiotic selection with the surgeon. 7. Antibiotics listed below are listed in order of preference. The first line antibiotic has been designated with an asterisks(*). Dose Surgical Procedure Drug Pediatrics (<80 kg), Wt <80 kg Wt 80-119 kg Wt ≥ 120 kg If applicable Coronary Artery Bypass Graft Cardiac Surgery cefazolin IV* 1 gm 2 gm 3 gm Vascular Surgery All CABG, Valves and other CV procedures Pacemakers, AICD’s, pocket vancomycin IV (MRSA or 1 gm 1.5 gm 2 gm relocation and lead revisions, allergy) generator replacements. Repair of the aorta Leg vessel bypasses Endarterectomy of the aorta clindamycin IV 900 mg Abdominal endarterectomy Abdominal vessel resection Intra-abdominal shunt Vascular shunt & bypass AV fistula daptomycin (MRSA or allergy) contact pharmacy cefazolin IV* 1 gm 2 gm 3 gm Hip Arthroplasty (full or partial) vancomycin IV (MRSA or 1 gm 1.5 gm 2 gm Knee Arthroplasty allergy) All Orthopedic and Podiatry cases clindamycin IV 900 mg daptomycin (MRSA or allergy) contact pharmacy 30 mg/kg cefazolin IV* 1 gm 2 gm 3 gm Neurological (max 1000 mg) Shunt insertion, replace or vancomycin IV (MRSA or 15 mg/kg revise 1 gm 1.5 gm 2 gm allergy) (max 1000 mg) Pain pumps 10 mg/kg Laminectomy clindamycin IV 900 mg Laminotomy (max 900 mg) Discectomy daptomycin (MRSA or allergy) contact pharmacy Head and Neck 30 mg/kg cefazolin IV* 1 gm 2 gm 3 gm (max 1000 mg) All jaw fracture repairs 15 mg/kg vancomycin IV (MRSA or 1 gm 1.5 gm 2 gm With or w/o interdental allergy) (max 1000 mg) fixation clindamycin IV PLUS 900 mg 900 mg PLUS Diverticulectomy of gentamicin IV PLUS 80 mg 120 mg hypopharynx or esophagus with or w/o myotomy, daptomycin (MRSA or allergy) contact pharmacy cervical approach Surgical Prophylaxis Antibiotic Recommendations Updated 2017 Dose Surgical Procedure Drug Pediatrics (<80 kg) Wt <80 kg Wt 80-119 kg Wt ≥ 120 kg If applicable vancomycin PLUS 15 mg/kg Colonized with MRSA 1 gm 1.5 gm 2 gm antibiotics listed below (max 1000 mg) 50 mg/kg ceftriaxone IV PLUS (max 1000 mg) 1 gm PLUS metronidazole IV* PLUS 15 mg/kg 500 mg (max 500 mg) 50 mg/kg cefotetan IV* 1 gm 2 gm 2 gm (max 1000 mg) During cefotetan shortage: 40 mg/kg Colon Surgery (open or lap) 2 gm Cecectomy cefoxitin (max 2000 mg) Hemicolectomy 10 mg/kg Sigmoidectomy ciprofloxacin IV PLUS (max 400 mg) 400 mg PLUS PLUS 15 mg/kg Anastomosis, including anal metronidazole IV 500 mg (max 500 mg) Resections, including rectal clindamycin IV PLUS 900 mg 900 mg PLUS Any laceration repair gentamicin IV PLUS 80 mg 120 mg Any intestinal/bowel incision clindamycin IV PLUS 900 mg PLUS aztreonam IV 2 gm clindamycin IV PLUS 900 mg PLUS ciprofloxacin IV 400 mg metronidazole IV PLUS 500 mg 500 mg PLUS gentamicin IV PLUS 80 mg 120 mg cefotetan IV* 1 gm 2 gm 2 gm During cefotetan shortage: 2 gm cefoxitin clindamycin IV PLUS 900 mg PLUS ciprofloxacin IV 400 mg ciprofloxacin IV PLUS 400 mg PLUS metronidazole IV 500 mg clindamycin IV PLUS 900 mg 900 mg PLUS Hysterectomy (any approach) gentamicin IV PLUS 80 mg 120 mg Hysterectomy (any approach) with colon clindamycin IV PLUS 900 mg PLUS procedure (any approach) aztreonam IV 2 gm 500 mg metronidazole IV PLUS 500 mg PLUS PLUS gentamicin IV 120 mg 80 mg vancomycin IV PLUS 1 gm PLUS 1.5 gm PLUS 2 gm PLUS gentamicin IV 80 mg 120 mg 120 mg vancomycin IV PLUS 1 gm PLUS 1.5 gm PLUS 2 gm PLUS aztreonam IV 2 gm 2 gm 2 gm Genitourinary cefazolin IV* 1 gm 2 gm 3 gm 500 mg ciprofloxacin PO (clearly document date/time taken if dose was taken PTA on day of surgery) Prostate biopsy sulfamethoxazole/ 800mg/160 mg Needle, punch or incisional (clearly document date/time taken if dose was trimethoprim PO approach taken PTA on day of surgery) gentamicin IV 80 mg 120 mg aztreonam IV 2 gm cefazolin IV PLUS 1 gm PLUS 2 gm PLUS 3 gm PLUS gentamicin IV* 80 mg 120 mg 120 mg vancomycin IV PLUS 1 gm PLUS 1.5 gm PLUS 2 gm PLUS gentamicin IV 80 mg 120 mg 120 mg gentamicin IV PLUS 80 mg PLUS 120 mg PLUS clindamycin IV 900 mg 900 mg Penile prosthesis aztreonam IV PLUS 2 gm PLUS Insertion, removal, revision clindamycin IV 900 mg aztreonam IV PLUS 2 gm PLUS 2 gm PLUS 2 gm PLUS vancomycin IV 1 gm 1.5 gm 2 gm aztreonam IV PLUS 2 gm PLUS 2 gm PLUS 2 gm PLUS cefazolin IV 1 gm 2 gm 3 gm Surgical Prophylaxis Antibiotic Recommendations Updated 2017 Dose Surgical Procedure Drug Pediatrics (<80 kg) Wt <80 kg Wt 80-119 kg Wt ≥ 120kg If applicable vancomycin PLUS 15 mg/kg Colonized with MRSA 1 gm 1.5 gm 2 gm antibiotics listed below (max 1000 mg) Gastric/Biliary 30 mg/kg cefazolin IV* 1 gm 2 gm 3 gm (max 1000 mg) 10 mg/kg (max 400 mg) ciprofloxacin IV PLUS 400 mg PLUS PLUS clindamycin IV 900 mg 10 mg/kg (max 900 mg) PEG placement clindamycin IV PLUS 900 mg 900 mg PLUS gentamicin IV PLUS 80 mg 120 mg vancomycin IV PLUS 1 gm PLUS 1.5 gm PLUS 2 g PLUS gentamicin IV 80 mg 120 mg 120 mg vancomycin IV PLUS 1 gm PLUS 1.5 gm PLUS 2 gm PLUS ciprofloxacin IV 400 mg 400 mg 400 mg cefotetan IV* 1 gm 2 gm 2 gm During cefotetan shortage: 2 gm cefoxitin clindamycin IV PLUS 900 mg PLUS ciprofloxacin IV 400 mg Pubovaginal Sling clindamycin IV PLUS 900 mg 900 mg PLUS gentamicin IV PLUS 80 mg 120 mg Sling operation for stress clindamycin IV PLUS 900 mg PLUS incontinence (fascia or aztreonam IV 2 gm synthetic) metronidazole IV PLUS 500 mg PLUS Paravaginal defect repair aztreonam IV 2 gm (including repair of 500 mg metronidazole IV PLUS 500 mg PLUS cystocele) PLUS gentamicin IV 120 mg 80 mg vancomycin IV PLUS 1 gm PLUS 1.5 gm PLUS 2 gm PLUS gentamicin IV 80 mg 120 mg 120 mg vancomycin IV PLUS 1 gm PLUS 1.5 gm PLUS 2 gm PLUS aztreonam IV 2 gm 2 gm 2 gm vancomycin IV PLUS 1 gm PLUS 1.5 gm PLUS 2 gm PLUS gentamicin IV 80 mg 120 mg 120 mg cefazolin IV once 1 GM 2 GM 3 GM 900 mg 900 mg Cesarean Delivery clindamycin IV once PLUS 900 mg PLUS PLUS PLUS gentamicin IV once 120 mg 120 80 mg mg Urologic 30 mg/kg Urologic without entry into the urinary cefazolin IV* 1 gm 2 gm 3 gm (max 1000 mg) tract 10 mg/kg clindamycin IV 900 mg (max 900 mg) 50 mg/kg cefotetan IV* 1 gm 2 gm 2 gm (max 1000 mg) Urologic involving entry into the urinary During cefotetan shortage: 40 mg/kg 2 gm tract or involving intestines cefoxitin (max 2000 mg) Bladder resections 10 mg/kg Gastrointestinal fistulas ciprofloxacin IV PLUS (max 400 mg) 400 mg PLUS metronidazole IV PLUS 15 mg/kg 500 mg (max 500 mg) Special Considerations: The only operations for which oral antibiotics alone are acceptable are the Prostate biopsy and Pubovaginal sling procedures. The only operations for which intramuscular antibiotics alone are acceptable are the Prostate biopsy procedures. For urologic and pubovaginal sling procedures only: If the patient took an oral antibiotic prior to arrival on the date of surgery – please clearly document name of drug, date and time taken. Surgical Prophylaxis Antibiotic Recommendations Updated 2017 Patient arrives in pre-op clinic or pre-op holding Do not swab; standard precautions; standard antibiotics No Has the Does Does patient had a patient meet No patient have a Yes positive MRSA culture surveillance policy history of at WMC or criteria? MRSA? Yes Yes WW? No Has the patient had a surveillance culture w/in last When No Yes 30 days? was culture >3 obtained? <3 yrs yrs Do not swab; Obtain a standard precautions; surveillance swab; Are Is there a standard antibiotics antibiotic selection there 3 negative based on results negative culture >3 yrs cultures (at least 30 Yes since the last positive days apart) since the culture? No last positive No culture? Remove from contact precautions; Yes notify Infection Prevention at WQA.IP; standard antibiotics Has patient received Mupirocin within 14 Yes days? Do not swab; No contact precautions; Swab; vancomycin contact precautions Remain in contact precautions; Are vancomycin Is it there results No > 3 yrs since the Yes available? last positive culture? Yes Are the results No negative? Remove from contact precautions; Yes notify Infection Prevention at WQA.IP; standard antibiotics No Notify surgeon; notify nursing management;
Load more

Recommended publications
  • Medical Review(S) Clinical Review
    CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 200327 MEDICAL REVIEW(S) CLINICAL REVIEW Application Type NDA Application Number(s) 200327 Priority or Standard Standard Submit Date(s) December 29, 2009 Received Date(s) December 30, 2009 PDUFA Goal Date October 30, 2010 Division / Office Division of Anti-Infective and Ophthalmology Products Office of Antimicrobial Products Reviewer Name(s) Ariel Ramirez Porcalla, MD, MPH Neil Rellosa, MD Review Completion October 29, 2010 Date Established Name Ceftaroline fosamil for injection (Proposed) Trade Name Teflaro Therapeutic Class Cephalosporin; ß-lactams Applicant Cerexa, Inc. Forest Laboratories, Inc. Formulation(s) 400 mg/vial and 600 mg/vial Intravenous Dosing Regimen 600 mg every 12 hours by IV infusion Indication(s) Acute Bacterial Skin and Skin Structure Infection (ABSSSI); Community-acquired Bacterial Pneumonia (CABP) Intended Population(s) Adults ≥ 18 years of age Template Version: March 6, 2009 Reference ID: 2857265 Clinical Review Ariel Ramirez Porcalla, MD, MPH Neil Rellosa, MD NDA 200327: Teflaro (ceftaroline fosamil) Table of Contents 1 RECOMMENDATIONS/RISK BENEFIT ASSESSMENT ......................................... 9 1.1 Recommendation on Regulatory Action ........................................................... 10 1.2 Risk Benefit Assessment.................................................................................. 10 1.3 Recommendations for Postmarketing Risk Evaluation and Mitigation Strategies ........................................................................................................................
    [Show full text]
  • Surgical Decolonization and Prophylaxis
    Surgical Decolonization and Prophylaxis SurgicalSurgical Decolonization Decolonization and Prophylaxis and Prophylaxis DECOLONIZATION DECOLONIZATION Nasal Screening Result Recommended Intervention Nasal Screening Result Recommended Intervention MRSA Negative • No decolonization required MSSAMRSA NegativeNegative • No decolonization required MSSA PositiveNegative • Intranasal mupirocin twice daily x 5 days MSSA Positive • Intranasal mupirocin twice daily x 5 days MRSA Positive • Intranasal mupirocin twice daily x 5 days, MRSA Positive AND• Intranasal mupirocin twice daily x 5 days, •ANDChlorhexidine bathing one day prior to surgery ANTIMICROBIAL• ChlorhexidinePROPHYLAXISbathing one day prior to surgery ANTIMICROBIAL PROPHYLAXIS CLINICAL CONSIDERATIONS • Preoperative dose-timing CLINICAL CONSIDERATIONS • PreoperativeWithin 60 minutesdose-timing of surgical incision WithinExceptions: 60 minutes vancomycin of surgicaland fluoroquinolones incision within 120 minutes of surgical incisionExceptions: vancomycin and fluoroquinolones within 120 minutes of surgical • Weightincision-based dosing • WeightCefazolin-based: 2 gm dosingfor patients <120 kg, and 3 gm for patients ≥120 kg Vancomycin:Cefazolin: 2 gm usefor ABW patients <120 kg, and 3 gm for patients ≥120 kg Gentamicin:Vancomycin: use use ABW ABW unless ABW is >120% of their IBW, in which case use AdjBWGentamicin:(see below use ABW for equation)unless ABW is >120% of their IBW, in which case use • DurationAdjBW of(see prophylaxis below for equation) • DurationA single of dose, prophylaxis
    [Show full text]
  • Antimicrobial Stewardship Guidance
    Antimicrobial Stewardship Guidance Federal Bureau of Prisons Clinical Practice Guidelines March 2013 Clinical guidelines are made available to the public for informational purposes only. The Federal Bureau of Prisons (BOP) does not warrant these guidelines for any other purpose, and assumes no responsibility for any injury or damage resulting from the reliance thereof. Proper medical practice necessitates that all cases are evaluated on an individual basis and that treatment decisions are patient-specific. Consult the BOP Clinical Practice Guidelines Web page to determine the date of the most recent update to this document: http://www.bop.gov/news/medresources.jsp Federal Bureau of Prisons Antimicrobial Stewardship Guidance Clinical Practice Guidelines March 2013 Table of Contents 1. Purpose ............................................................................................................................................. 3 2. Introduction ...................................................................................................................................... 3 3. Antimicrobial Stewardship in the BOP............................................................................................ 4 4. General Guidance for Diagnosis and Identifying Infection ............................................................. 5 Diagnosis of Specific Infections ........................................................................................................ 6 Upper Respiratory Infections (not otherwise specified) ..............................................................................
    [Show full text]
  • AMEG Categorisation of Antibiotics
    12 December 2019 EMA/CVMP/CHMP/682198/2017 Committee for Medicinal Products for Veterinary use (CVMP) Committee for Medicinal Products for Human Use (CHMP) Categorisation of antibiotics in the European Union Answer to the request from the European Commission for updating the scientific advice on the impact on public health and animal health of the use of antibiotics in animals Agreed by the Antimicrobial Advice ad hoc Expert Group (AMEG) 29 October 2018 Adopted by the CVMP for release for consultation 24 January 2019 Adopted by the CHMP for release for consultation 31 January 2019 Start of public consultation 5 February 2019 End of consultation (deadline for comments) 30 April 2019 Agreed by the Antimicrobial Advice ad hoc Expert Group (AMEG) 19 November 2019 Adopted by the CVMP 5 December 2019 Adopted by the CHMP 12 December 2019 Official address Domenico Scarlattilaan 6 ● 1083 HS Amsterdam ● The Netherlands Address for visits and deliveries Refer to www.ema.europa.eu/how-to-find-us Send us a question Go to www.ema.europa.eu/contact Telephone +31 (0)88 781 6000 An agency of the European Union © European Medicines Agency, 2020. Reproduction is authorised provided the source is acknowledged. Categorisation of antibiotics in the European Union Table of Contents 1. Summary assessment and recommendations .......................................... 3 2. Introduction ............................................................................................ 7 2.1. Background ........................................................................................................
    [Show full text]
  • Antibiotic Review
    8/28/19 Disclosure 2 E. Monee’ Carter-Griffin DNP, MA, RN, ACNP-BC Antibiotic has no financial relationships with commercial Review interests to disclose. Any unlaBeled and/or E. Monee’ Carter-Griffin, DNP, MA, RN, ACNP-BC unapproved uses of drugs or products will Be Associate Chair for Advanced Practice Nursing disclosed. University of Texas at Arlington, College of Nursing & Health Innovation Dallas Pulmonary & Critical Care, PA • Identify the general characteristics of • SusceptiBility à determine which antibiotics. antibiotics a bacteria is sensitive to • Discuss the mechanism of action, • à pharmacokinetics, and spectrum of activity MIC lowest concentration of drug that inhiBits growth of the Bacteria for the most common antiBiotic drug classes. Antibiotic Objectives • Identify commonly prescriBed antiBiotics • Trough à lowest concentration of within the drug classes including dosage Lingo drug in bloodstream range and indication for prescribing. – Collect prior to administration of • Identify special considerations for specific drug antibiotics and/or drug classes. • Peak à highest concentration of • Practice appropriate prescriBing for common drug in bloodstream bacterial infections. • Review Basic antiBiotic stewardship 3 4 principles. • Penicillins • Bactericidal or bacteriostatic • Cephalosporins • Narrow or Broad spectrum • Carbapenems General • Can elicit allergic responses Antibiotic • MonoBactam Characteristics • Affect normal Body flora Drug Classes • Macrolides • Fluoroquinolones • Sulfonamides • Tetracyclines 5 6 1 8/28/19 • Penicillins – Natural penicillins 8 – Aminopenicillins Penicillins Penicillins – Anti-staphylococcal penicillins • Mechanism of action àbactericidal à – Anti-pseudomonal penicillins interrupts cell wall synthesis 7 • Pharmacokinetics • Spectrum of Activity – Gram positive organisms Natural – Penicillin G à mostly given IM, But Natural • Streptococcus species (e.g. S. Penicillins one variation can Be given IV Penicillins pyogenes) • Poorly aBsorBed via PO • Some enterococcus species (e.g.
    [Show full text]
  • Computational Antibiotics Book
    Andrew V DeLong, Jared C Harris, Brittany S Larcart, Chandler B Massey, Chelsie D Northcutt, Somuayiro N Nwokike, Oscar A Otieno, Harsh M Patel, Mehulkumar P Patel, Pratik Pravin Patel, Eugene I Rowell, Brandon M Rush, Marc-Edwin G Saint-Louis, Amy M Vardeman, Felicia N Woods, Giso Abadi, Thomas J. Manning Computational Antibiotics Valdosta State University is located in South Georgia. Computational Antibiotics Index • Computational Details and Website Access (p. 8) • Acknowledgements (p. 9) • Dedications (p. 11) • Antibiotic Historical Introduction (p. 13) Introduction to Antibiotic groups • Penicillin’s (p. 21) • Carbapenems (p. 22) • Oxazolidines (p. 23) • Rifamycin (p. 24) • Lincosamides (p. 25) • Quinolones (p. 26) • Polypeptides antibiotics (p. 27) • Glycopeptide Antibiotics (p. 28) • Sulfonamides (p. 29) • Lipoglycopeptides (p. 30) • First Generation Cephalosporins (p. 31) • Cephalosporin Third Generation (p. 32) • Fourth-Generation Cephalosporins (p. 33) • Fifth Generation Cephalosporin’s (p. 34) • Tetracycline antibiotics (p. 35) Computational Antibiotics Antibiotics Covered (in alphabetical order) Amikacin (p. 36) Cefempidone (p. 98) Ceftizoxime (p. 159) Amoxicillin (p. 38) Cefepime (p. 100) Ceftobiprole (p. 161) Ampicillin (p. 40) Cefetamet (p. 102) Ceftoxide (p. 163) Arsphenamine (p. 42) Cefetrizole (p. 104) Ceftriaxone (p. 165) Azithromycin (p.44) Cefivitril (p. 106) Cefuracetime (p. 167) Aziocillin (p. 46) Cefixime (p. 108) Cefuroxime (p. 169) Aztreonam (p.48) Cefmatilen ( p. 110) Cefuzonam (p. 171) Bacampicillin (p. 50) Cefmetazole (p. 112) Cefalexin (p. 173) Bacitracin (p. 52) Cefodizime (p. 114) Chloramphenicol (p.175) Balofloxacin (p. 54) Cefonicid (p. 116) Cilastatin (p. 177) Carbenicillin (p. 56) Cefoperazone (p. 118) Ciprofloxacin (p. 179) Cefacetrile (p. 58) Cefoselis (p. 120) Clarithromycin (p. 181) Cefaclor (p.
    [Show full text]
  • Cephalosporins Can Be Prescribed Safely for Penicillin-Allergic Patients ▲
    JFP_0206_AE_Pichichero.Final 1/23/06 1:26 PM Page 106 APPLIED EVIDENCE New research findings that are changing clinical practice Michael E. Pichichero, MD University of Rochester Cephalosporins can be Medical Center, Rochester, NY prescribed safely for penicillin-allergic patients Practice recommendations an allergic reaction to cephalosporins, ■ The widely quoted cross-allergy risk compared with the incidence of a primary of 10% between penicillin and (and unrelated) cephalosporin allergy. cephalosporins is a myth (A). Most people produce IgG and IgM antibodies in response to exposure to ■ Cephalothin, cephalexin, cefadroxil, penicillin1 that may cross-react with and cefazolin confer an increased risk cephalosporin antigens.2 The presence of of allergic reaction among patients these antibodies does not predict allergic, with penicillin allergy (B). IgE cross-sensitivity to a cephalosporin. ■ Cefprozil, cefuroxime, cefpodoxime, Even penicillin skin testing is generally not ceftazidime, and ceftriaxone do not predictive of cephalosporin allergy.3 increase risk of an allergic reaction (B). Reliably predicting cross-reactivity ndoubtedly you have patients who A comprehensive review of the evidence say they are allergic to penicillin shows that the attributable risk of a cross- U but have difficulty recalling details reactive allergic reaction varies and is of the reactions they experienced. To be strongest when the chemical side chain of safe, we often label these patients as peni- the specific cephalosporin is similar to that cillin-allergic without further questioning of penicillin or amoxicillin. and withhold not only penicillins but Administration of cephalothin, cepha- cephalosporins due to concerns about lexin, cefadroxil, and cefazolin in penicillin- potential cross-reactivity and resultant IgE- allergic patients is associated with a mediated, type I reactions.
    [Show full text]
  • A Thesis Entitled an Oral Dosage Form of Ceftriaxone Sodium Using Enteric
    A Thesis entitled An oral dosage form of ceftriaxone sodium using enteric coated sustained release calcium alginate beads by Darshan Lalwani Submitted to the Graduate Faculty as partial fulfillment of the requirements for the Master of Science Degree in Pharmaceutical Sciences with Industrial Pharmacy Option _________________________________________ Jerry Nesamony, Ph.D., Committee Chair _________________________________________ Sai Hanuman Sagar Boddu, Ph.D, Committee Member _________________________________________ Youssef Sari, Ph.D., Committee Member _________________________________________ Patricia R. Komuniecki, PhD, Dean College of Graduate Studies The University of Toledo May 2015 Copyright 2015, Darshan Narendra Lalwani This document is copyrighted material. Under copyright law, no parts of this document may be reproduced without the expressed permission of the author. An Abstract of An oral dosage form of ceftriaxone sodium using enteric coated sustained release calcium alginate beads by Darshan Lalwani Submitted to the Graduate Faculty as partial fulfillment of the requirements for the Master of Science Degree in Pharmaceutical Sciences with Industrial Pharmacy option The University of Toledo May 2015 Purpose: Ceftriaxone (CTZ) is a broad spectrum semisynthetic, third generation cephalosporin antibiotic. It is an acid labile drug belonging to class III of biopharmaceutical classification system (BCS). It can be solvated quickly but suffers from the drawback of poor oral bioavailability owing to its limited permeability through
    [Show full text]
  • INVANZ, INN-Ertapenem
    EMA/665637/2016 EMEA/H/C/000389 EPAR summary for the public Invanz ertapenem This is a summary of the European public assessment report (EPAR) for Invanz. It explains how the Agency assessed the medicine to recommend its authorisation in the EU and its conditions of use. It is not intended to provide practical advice on how to use Invanz. For practical information about using Invanz, patients should read the package leaflet or contact their doctor or pharmacist. What is Invanz and what is it used for? Invanz is an antibiotic. It is used in adults and children aged over 3 months to treat the following infections: • infections within the abdomen; • community-acquired pneumonia (infection of the lungs caught away from hospital); • gynaecological infections; • foot infections in diabetes patients. Invanz is also used in adults to prevent infection after colorectal surgery (surgery in the lower part of the bowel, including the rectum). Invanz is used when the bacteria that cause the infection are likely to be killed by the antibiotic. Before using Invanz, doctors should consider official guidance on the appropriate use of antibiotics. Invanz contains the active substance ertapenem. How is Invanz used? Invanz is available as a vial containing a powder which is dissolved before use to make up a solution for infusion (drip) into a vein. It is infused over 30 minutes. The medicine can only be obtained with a prescription. 30 Churchill Place ● Canary Wharf ● London E14 5EU ● United Kingdom Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5555 Send a question via our website www.ema.europa.eu/contact An agency of the European Union © European Medicines Agency, 2016.
    [Show full text]
  • Medication Shortages: March 2019
    Medication shortages March 26,2019 Analgesia/Addiction • Fentanyl Citrate (Sublimaze) Injection (Currently in Shortage) • Hydromorphone Hydrochloride Injection, USP (Currently in Shortage) • Ketoprofen Capsules (Currently in Shortage) • Ketorolac Tromethamine Injection (Currently in Shortage) • Methadone Hydrochloride Injection (Currently in Shortage) • Methocarbamol Tablets (Currently in Shortage) • Morphine Sulfate Injection, USP (Currently in Shortage) • Promethazine (Phenergan) Injection (Currently in Shortage) • Remifentanil (Ultiva) Lyophilized Powder for Solution Injection (Currently in Shortage) Anesthesia • Atropine Sulfate Injection (Currently in Shortage) • Bupivacaine Hydrochloride and Epinephrine Injection, USP (Currently in Shortage) • Bupivacaine Hydrochloride Injection, USP (Currently in Shortage) • Ketamine Injection (Currently in Shortage) • Lidocaine Hydrochloride (Xylocaine) Injection (Currently in Shortage) • Lidocaine Hydrochloride (Xylocaine) Injection with Epinephrine (Currently in Shortage) • Methadone Hydrochloride Injection (Currently in Shortage) • Ropivacaine Hydrochloride Injection (Currently in Shortage) Anti-Infective • Cefazolin Injection (Currently in Shortage) • Cefepime Injection (Currently in Shortage) • Cefotaxime Sodium (Claforan) Injection (Currently in Shortage) • Cefotetan Disodium Injection (Currently in Shortage) • Cycloserine Capsules, USP (Currently in Shortage) • Erythromycin Lactobionate for Injection, USP (Currently in Shortage) • Gemifloxacin Mesylate (Factive) Tablets (Currently in Shortage)
    [Show full text]
  • Surgical Antibiotic Prophylaxis
    Surgical Antibiotic Prophylaxis - Adult Page 1 of 6 Disclaimer: This algorithm has been developed for MD Anderson using a multidisciplinary approach considering circumstances particular to MD Anderson’s specific patient population, services and structure, and clinical information. This is not intended to replace the independent medical or professional judgment of physicians or other health care providers in the context of individual clinical circumstances to determine a patient's care. This algorithm should not be used to treat pregnant women. Local microbiology and susceptibility/resistance patterns should be taken into consideration when selecting antibiotics. Patients scheduled for surgery should have the following antibiotics administered prior to their procedure: ● Vancomycin, ciprofloxacin/levofloxacin, and gentamicin are to be initiated 60 to 120 minutes prior to incision, and all other antibiotics are to be initiated within 60 minutes of incision ● Carefully evaluate allergy histories before using alternative agents - the majority of patients with listed penicillin allergies can safely be given cephalosporins or carbapenems ● If the patient has multiple known antibiotic drug allergies, is colonized with or has a history of a recent multi-drug infection, administer antibiotics as indicated or consider an outpatient Infectious Diseases consultation ● Discontinue all antibiotics within 24 hours of first dose except for: 1) Treatment of established infection, 2) Prophylaxis of prosthesis in the setting of postoperative co-located
    [Show full text]
  • The New Fifth-Generation Cephalosporins – a Balance Between Safety and Efficacy
    REVIEWS Ref: Ro J Pharm Pract. 2020;13(3) DOI: 10.37897/RJPhP.2020.3.2 The new fifth-generation cephalosporins – a balance between safety and efficacy Aura Rusu1, Ioana-Andreea Lungu2 1 Pharmaceutical and Therapeutical Chemistry Department, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania 2 Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania Abstract Cephalosporins are beta-lactam antibiotics classified into five generations. The newest generation has three representa- tives: ceftaroline fosamile, the combination ceftolozane/tazobactam (cephalosporin/beta-lactamase inhibitor), and ceftobi- prole medocaril. These new cephalosporins are valuable anti-infective agents, with potent activity against multidrug-re- sistant bacteria, and with a positive balance between benefits and side effects. However, the fifth-generation cephalosporins should be judiciously used to prevent the occurrence of bacterial resistance phenomenon. Keywords: cephalosporins, ceftaroline, ceftolozane, ceftobiprole, MRSA, community-acquired pneumonia, complicated skin and soft tissue infections INTRODUCTION emerged as a result of increased only, in the situation where other Cephalosporins (CFs) are beta- bacterial resistance to classical antibacterial drugs were not lactam antibiotics with numerous antibiotics. Based on the efficient. representatives widely used in the antimicrobial activity, the CFs are therapy
    [Show full text]