Primaxin Shortage

[ItsOverZyvox]

What is your hospital doing about it?

I guess it's gearing to generic. It's an excellen thing.

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[tussionex]

nothing yet.....just denial.


maybe invanz, but so will everyone and their brother.

 

[WVUPharm2007]

I think we plan on shrugging our shoulders and throwing Miss Cleocin and cefepime or ertapenem at them....then running away. Really our plan is to tell them we have no Primaxin and making them come up with their own damn broad spectrum crap.

We HAVE been chucking quite a ton of cefepime at people though. I didn't even know there WAS a Primaxin shortage until a few weeks ago when I actually said I was surprised by how little Primaxin we used in comparison to everywhere else I've ever been. Then they all look at me with the stare of death like "**** YOU NEWBIE!!!" I was surprised at how much Tygacil we use, too.

 

[ItsOverZyvox]

Can't use invanz for primaxin.

Doribax is the cost effective option. Merrem is higher if you haven't had the marketshare.

 

[njac]

We've got a little bit of meropenem worst case scenario. I have no idea what they're doing at the hospital where I work since I'm only working saturdays due to rotations.

I D/C'd our only current primaxin patient to hospice today so we just aren't letting anyone write for it at the moment.

 

[ItsOverZyvox]

No stock of primaxin at your wholesaler warehouse folks..

 

[njac]

I think we plan on shrugging our shoulders and throwing Miss Cleocin and cefepime or ertapenem at them....then running away. Really our plan is to tell them we have no Primaxin and making them come up with their own damn broad spectrum crap.

We HAVE been chucking quite a ton of cefepime at people though. I didn't even know there WAS a Primaxin shortage until a few weeks ago when I actually said I was surprised by how little Primaxin we used in comparison to everywhere else I've ever been. Then they all look at me with the stare of death like "**** YOU NEWBIE!!!" I was surprised at how much Tygacil we use, too.

It's interesting how different hospitals, even in the same city, have different usages. I've seen 2 patients on cefepime in the 10 days I've been on this rotation vs. filling it daily when I'm at work.

I guess it's also the difference in patient populations too. Lots and lots of CAP here.

 

[ItsOverZyvox]

Every hospital has different culture.

 

[elwademd]

Every hospital has different culture.

well, hopefully every hospital has an antibiogram that helps to decide empiric therapy... as opposed to physicians just ordering whatever antibiotic they want to.

 

[WVUPharm2007]

well, hopefully every hospital has an antibiogram that helps to decide empiric therapy... as opposed to physicians just ordering whatever antibiotic they want to.

Lol....like a power vacuum when a dictator gets whacked.

 

[WVUPharm2007]

Doribax is the cost effective option.

WTF? Didn't that stuff just come out? Usually the newer it is, the more ridiculously expensive it is.

 

[Priapism321]

Every hospital has different culture.

Carbapenems in two patients per week (700 bed institution) = who cares

Our ID pharmacists would just tell them the 9 reasons carbapenems are not necessary in almost every given situation, and why for most gram negative infections (minus acinetobacter, apparently), meropenem is more effective.

 

[ItsOverZyvox]

WTF? Didn't that stuff just come out? Usually the newer it is, the more ridiculously expensive it is.

Actually, new entry into a competitive market means they'll play pricing game to slightly undercut others to gain marketshare.

Spend a day with your purchaser and learn how to order...and see if your purchaser is ordering best priced drugs.

 

[ItsOverZyvox]

Carbapenems in two patients per week (700 bed institution) = who cares

Our ID pharmacists would just tell them the 9 reasons carbapenems are not necessary in almost every given situation, and why for most gram negative infections (minus acinetobacter, apparently), meropenem is more effective.

2 patients on carbapenems? That's unbelievable. Didn't someone say diabetic foot infection is nothing more than Imipenem Defficiency?

Well..add ESBL producing bugs for penems...and what you gonna do for resistant Acinetobacter? I gots me a hospital with about 50% resistant Acinetobacter..

 

[tussionex]

Can't use invanz for primaxin.

.

why not?

 

[ItsOverZyvox]

why not?

Invanz doesn't have pseudomonal coverage.

If we're talking about intra-abdominal infections, then sure we can use Invanz but Imipenem really shouldn't be the first choice anyways.. but Ceftriaxone + Metronidazole should be.

But for VAP or HAP with pseudomonal risk, Invanz is a No No.

 

[slaitken]

I was under the impression that it was only the ADD-vantage vials that were currently in a shortage. We're switching to the Minibags from Baxter, but I don't know how that would work out if it's every dosage form that's running out.

 

[Priapism321]

Well..add ESBL producing bugs for penems...and what you gonna do for resistant Acinetobacter? I gots me a hospital with about 50% resistant Acinetobacter..

colistin.

 

[ItsOverZyvox]

colistin.

How much is that? I can't seem to find a supplier..

 

[tussionex]

Invanz doesn't have pseudomonal coverage.

If we're talking about intra-abdominal infections, then sure we can use Invanz but Imipenem really shouldn't be the first choice anyways.. but Ceftriaxone + Metronidazole should be.

But for VAP or HAP with pseudomonal risk, Invanz is a No No.

good to know, thanks!

i work in IT now, so i don't actually NEED to know this. i spend my time now making sure my pharmacists can use a safe, effecient, user friendly system. i leave the ID to someone else.