Trouble with antibiotics and coverage

[SomethingFishy]

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I've recently had a lot of trouble determining what abx to use to cover pts in house. GI infections, PNA really give me trouble and just in general I don't have a good idea as to what covers what. Does anyone have a good resource they use? I realize that each hospital has certain sensitivities and resistant patterns, but I'm looking for a general, easy to use guideline on what abx's cover what. Thanks!

 

[SLUser11]

I've recently had a lot of trouble determining what abx to use to cover pts in house. GI infections, PNA really give me trouble and just in general I don't have a good idea as to what covers what. Does anyone have a good resource they use? I realize that each hospital has certain sensitivities and resistant patterns, but I'm looking for a general, easy to use guideline on what abx's cover what. Thanks!

Abdominal infection: Zosyn
Pneumonia: Zosyn
Toe infection: Zosyn
Runny nose: Zosyn


Hope that helps!








Sorry, had to take a shot at my beloved specialty......the old joke goes: What's the difference between a monkey and a surgical resident? A monkey can name 2 antibiotics.

An honest answer to your question is that antibiotics are regional. For instance, we never really use Unasyn around here, but it's big time in areas on the east coast........

If I get more energy later, I'll give you an honest and helpful reply....

 

[N-Surge]

I've recently had a lot of trouble determining what abx to use to cover pts in house. GI infections, PNA really give me trouble and just in general I don't have a good idea as to what covers what. Does anyone have a good resource they use? I realize that each hospital has certain sensitivities and resistant patterns, but I'm looking for a general, easy to use guideline on what abx's cover what. Thanks!

Sanfords (Blackberry version) is what I carry, along with the free Epocrates.

If it's in the middle of the night on call, when in doubt, call pharmacy to give you a hand.

 

[ussdfiant]

Go to one of your upper years and ask where to get your hospital's antibiogram. Sanford's guide, as mentioned above, is an excellent resource. Can't go wrong with a 3rd gen cephalosporin + a macrolide for community acquired PNA.

 

[elwademd]

I've recently had a lot of trouble determining what abx to use to cover pts in house. GI infections, PNA really give me trouble and just in general I don't have a good idea as to what covers what. Does anyone have a good resource they use? I realize that each hospital has certain sensitivities and resistant patterns, but I'm looking for a general, easy to use guideline on what abx's cover what. Thanks!

infectious disease society of america, system based standards/practice guidelines :

http://www.idsociety.org/Content.aspx?id=9088

 

[filter07]

Antibiotics... very simple. 3 options.
1. empiric vanc/cefepime or 4th gen
2. call pharmacy
3. ID consult

Seems like you are in IM so attendings might care about the "right" antibiotics... well, that's their anal retentive problem, not yours. Antibiotic susceptibility changes hospital to hospital, region by region, and over time. There's precious little theory and a mountain of empiric data. So just look it up or ask someone. There's no mystery. Hope that helps.

 

[PeachyKeen22]

I'm not a resident or intern, but MS3 doing a rotation in ID Consult. Don't know if my answers will be good enough, but you can verify with someone else.

In general GI infections, you want to cover gram negs and anaerobes. Cipro is good for gram negs, Clindamycin is good for anaerobes. If you've got confirmed gram pos like strep pneumo or enterococci, a penicillin med is usually okay but you have to check sensitivities.

I have nothing on pneumonias- I learned that you really have to make sure it's infectious 1st. Try to culture your bug because it could be anything!

 

[paiute]

The Medical Letter publishes a useful, easy to read, succinct guide to the use of antimicrobials. See their website. I printed it up and carry a copy with me in the hospital. It's only a few pages and is easy to understand.