Sepsis Antibiotic Administration For More Information Surviving Sepsis Guidelines avail- Why it Matters able at: www.survivingsepsis.org Antimicrobial Stewardship Site Surviving Sepsis Campaign Guidelines recommend initiating empiric antibiotics within Leads 1 hour from identification of sepsis. Initiation of the broadest range of antibacterial AMC: Matthew Bauer, DO and Zach activity first is imperative due to increasingly poor outocomes associated with delays Jenkins PharmD in appropriate therapy. GSH: Grant Starrett, MD and Jon Bachna PharmD Recommended Order of Administration for Antibiotics MVH: Steve Burdette, MD and Craig Pleiman PharmD
Commonly Used in Sepsis UVMC: Ron Manis, MD and Mike Bar- If compatible multiple antibiotics can be administered concurrently. When incom- horst PharmD patible or compatability unknown adminster those toward the top the chart first in order to administer broader spectrum agents first. When Administering 2 Antibiotics When Administering ≥3 Antibiotics
Beta-lactams; Broad Spectrum Beta-lactams: Broad Spectrum Ceftriaxone (ROCEPHIN) Ceftriaxone (ROCEPHIN) Cefepime (MAXIPIME) Cefepime (MAXIPIME) Ertapenem (INVANZ) Ertapenem (INVANZ) Meropenem (MERREM) Meropenem (MERREM) Piperacillin / Tazobactam (ZOSYN) Piperacillin / Tazobactam (ZOSYN)
One of the above broad spectrum beta-lactams administered?
YES NO Fluoroquinolone / Monobactam Levofloxacin (LEVAQUIN) MRSA Therapy Fluoroquinolone / Monobactam Aztreonam (AZACTAM) Vancomycin Levofloxacin (LEVAQUIN) Linezolid (ZYVOX) Aztreonam (AZACTAM)
Miscellaneous Vancomycin Fluoroquinolone / Monobactam MRSA Therapy Linezolid (ZYVOX) Levofloxacin (LEVAQUIN) Vancomycin Metronidazole (FLAGYL) Aztreonam (AZACTAM) Linezolid (ZYVOX) Azithromycin (ZITHROMAX) Clindamycin (CLEOCIN)
Miscellaneous Metronidazole (FLAGYL) Azithromycin (ZITHROMAX) Clindamycin (CLEOCIN)
7/2017 The above guideline should be utilized in conjunction with evaluation of the patient’s clinical status and the clinicians professional judgement.
Y-Site Compatibility of Commonly Used Antimicrobials
C = compatible at standard concentrations I = incompatible or insufficient information Gray boxes = medications not routinely administered together Note: This table is not meant to be be all inclusive and is reflective of standard concentrations and diluents used at Premier Health. Contact pharmacy if clarification necessary.