Oral Vanco for dental abscess...

[ldiot]

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So a patient hands my tech a script for oral vanco and asks if she should stop or continue her clinda with it. I'm thinking obviously not since clinda probably caused c. diff but asked her why she's taking these. She said she went to her dentist for an abscess and was referred to a surgeon for incision and drainage with a fever and severe pain.. Culture came back and they wanted to switch her antibiotic.

Told the patient I'm going to call the doctor, surgeon pulls up the ID and sensitivity and said it's resistant to everything except ceftriaxone and vanco, and since ceftriaxone is IV only he and the dentist agreed on oral vanco.

I thought this is so obviously stupid I must be missing something? Got him to change to cefdinir after explaining that ceftriaxone and cefdinir are both third-generation cephlasporins and oral vanco won't do anything systemically.

 

[WVUPharm2007]

Looks like you did a fine job to me.

 

[ValeRx]

Oral vanc only works on cdiff.

 

[owlegrad]

Yup, I got the exact opposite order once for IV vancomycin for cdiff. I was so sure it would be a simple cause of the wrong diagnosis but no it turns out it really was ordered that way.

Anyway good job getting a bad script changed.

 

[ldiot]

Some kind of strep

 

[Sine Cura]

I would laugh if they asked to have it compounded as an oral magic mouthwash

 

[Rockinacoustic]

Good catch. Hopefully the patient was appreciative.

Some kind of strep

Maybe S. anginosus? weird that is was PCN resistant

 

[ldiot]

Well they said it's resistant to everything except vanco and ceftriaxone, but the patient had a PCN allergy so maybe they weren't counting it since it was already ruled out.