P4 Rotations/Clerkships Survival Guide/Tips

[ItsOverZyvox]

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yeah but no medical history - this would be a community acquired bug.

He had a little bacteria on his UA but the culture hadn't come back yet when I left Thursday. I'm very curious to see what was going on there. Super nice guy with a super nice family too 😕

Well, if he has a GI thingamajig, then UA won't show much nor will you really get a C/S for an intra-ab infection... so you gotta rely on empiric tx.. what's the resistance patter look like in the community...

I need to go refresh up on the IDSA guideline on GI again.. dang I keep forgetting this stuff.

 

[ItsOverZyvox]

I was aware of ESBLs... I was thinking that the usage of said medications was indicative of the resistance profile. Its the real world application part that I was missing. I would have felt comfortable using either one of the Cefs for enterobacter - but leaning towards ceftriaxone, Cefotetan was only discussed "in class" for use with anaerobes (along with cefoxitin).

I feel like a little fish, swimming in the same pond as Glycerin and Njac. Ask me again after christmas - when I have 4 hospital rotations under my belt 😉

~above~

Glycerin and njac are much smarter than I ever was when I was getting out of my rotation..

Don't you work at a hospital yet?

 

[njac]

Well, if he has a GI thingamajig, then UA won't show much nor will you really get a C/S for an intra-ab infection... so you gotta rely on empiric tx.. what's the resistance patter look like in the community...

I need to go refresh up on the IDSA guideline on GI again.. dang I keep forgetting this stuff.

well GI was an assumption due to increasing abdominal girth. And bacteria on UA could be due to messy foley placement.

It was really a matter of 😕 - a diagnostic paracentesis had beautiful clear straw colored fluid. We (well they, I watched) took 4L off him later in the morning.

 

[PharmDstudent]

Does anyone use dapto for VRE? It's not FDA approved, but my preceptor gives it the approval. 😉 The dapto drug trials were held in this area, whenever they were still freaked out by the renal toxicity, so I guess it's used more often here because of the trials. I don't know for sure, though.

My IPPE clinical preceptor is an ID consultant at a teaching hospital, and dapto was used in a VRE case that I had to present. It's too bad that I have this "rotation" during the middle of the semester. 🙁 I would learn so much more from the experience if I wasn't trying to make it to the finish line in this marathon called pharmacy school.

 

[ItsOverZyvox]

well GI was an assumption due to increasing abdominal girth. And bacteria on UA could be due to messy foley placement.

It was really a matter of 😕 - a diagnostic paracentesis had beautiful clear straw colored fluid. We (well they, I watched) took 4L off him later in the morning.

gross... I'ma stick to my desk job.