post surgery prophylaxis

[baronzb]

Do the regimens for post-surgical prophylaxis ever change, meaning can pharmacy ever recommed a change, including if c/s come back negative, vitals fine, etc. I noticed patients on 5-20 weeks of post surgical prophylaxis.

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[Dred Pirate]

I might be missing something but what type of surgery is 5-20 weeks prophy? Post surgical prophy by definition is 24 hours max or you get "dinged" by CMS - there is a exception for cardiac - but it is still 48 hours

 

[Xarelto-10]

Do the regimens for post-surgical prophylaxis ever change, meaning can pharmacy ever recommed a change, including if c/s come back negative, vitals fine, etc. I noticed patients on 5-20 weeks of post surgical prophylaxis.

Post surgical prophylaxis is based on the premise having certain abx’s onboard pre and post procedure decreases chance of infection.

Most of the time antibiotics for this purpose should be dc’d within 24 hours of the pre-op dose. In some cases if having the abx maybe needed if pt develops infection or there is a secondary indication.

Because most of the times providers just copy paste progress notes to save time, they may not have updated the indication for the abx has changed ( one possible scenario) but off-course you should investigate it more to make sure bc I sometimes have caught such abxs after pt has been on these abxs for days and days.

It can also be pharmacy error- that sometimes pharmacist forgot to put a “hard stop”

 

[samven582]

Post surgical prophylaxis is based on the premise having certain abx’s onboard pre and post procedure decreases chance of infection.

Most of the time antibiotics for this purpose should be dc’d within 24 hours of the pre-op dose. In some cases if having the abx maybe needed if pt develops infection or there is a secondary indication.

Because most of the times providers just copy paste progress notes to save time, they may not have updated the indication for the abx has changed ( one possible scenario) but off-course you should investigate it more to make sure bc I sometimes have caught such abxs after pt has been on these abxs for days and days.

It can also be pharmacy error- that sometimes pharmacist forgot to put a “hard stop”

Isn't the hard stop built into the order panel/set?

 

[rxkrafted]

There is no reason why abx should be for that long for post-op prophylaxis... either its for a different indication or like how others are saying, maybe forgot to put a stop on it. Why haven't you asked the doctor doing this?

 

[BidingMyTime]

Yeah, did you mean 5 - 20 days? Although even that would make no sense. But 5 - 20 *weeks* post surge prophylaxis makes zero sense. Sounds like your computer system is screwy. Is this patient actually taking weeks of antibiotics, or is it that the hospital system is connected with the outpatient system, and the meds were never actually DC'd? Sometime "orders" will stay active forever, even though the med was for short term use and the patient no longer takes it. Especially for outpatient surgery.

 

[Xarelto-10]

Isn't the hard stop built into the order panel/set?

Depends on the institution. Some are more advanced in Thor quality of ca e and others are still in a reactive mode. Won’t fix the system until something bad happens or their bottom line is hurt ...

But I think pharmacists should catch it too. I mean, there’s pretty much a hard stop on many orders and the physician must review and approve if he thinks the Med should be continued.

 

[confettiflyer]

lol 20 weeks is longer than the dx definitive treatment duration of run of the mill osteo.

This better be some sort of lung procedure and they found XDR TB or something!

PS that’s a joke btw, somehow I feel the need to clarify that, hahah