|
|
Reference
| Institutional
Antimicrobial Control Program |
| |
All
departments will utilize the designated Adult Infectious Diseases
Approval source except the following:
| Department |
Approval Source |
| |
|
| OB/GYN |
Drs. W. Ledger or R. Sassoon |
| Pediatrics |
Division of Pediatric Infectious
Diseases |
| Surgery |
Surgical Intensive Care
Unit (2S) — Dr. P. Barie |
| |
Burn Unit (8W, 8S)
— Dr. R. Yurt |
| |
CT Surgery —
Dr. S. Chang |
All
nonformulary antimicrobial agents require approval from the
appropriate advisory source prior to the initiation of therapy.
| Phone Numbers: |
| Clinical Microbiology Laboratory |
6-2400 |
| Department of Epidemiology |
6-1754 |
| Divison of Adult Infectious
Diseases |
6-6320 |
Restricted Antimicrobials
Approval
 Beeper
(212-746-6700) |
#17022 |
|
|
| Clinical Pharmacist for
Infectious Diseases |
|
| Maryam
Behta, PharmD |
6-5487 |
|
Drug Information Center
|
6-0741 |
INSTITUTIONAL
ANTIMICROBIAL CONTROL PROGRAM RESTRICTIONS
| Class I |
Unrestricted formulary agents not listed in the following
two classes.
|
| Class II |
Antimicrobials approved for general use providing pre-determined
dosing parameters are not exceeded. If predetermined
parameters are exceeded, the prescribing physician must
obtain approval from the appropriate advisory source
prior to use.
|
Ampicillin/Sulbactam
|
3 gm Q6H not exceeded
|
|
Aztreonam
|
1 gm Q8H not exceeded
|
|
Cefazolin
|
1 gm Q8H not exceeded
|
|
Cefoxitin
|
2 gm Q6H or surgical prophylaxis >24 hours
not exceeded
|
|
Ceftriaxone
|
1 gm Q24H not exceeded
|
|
Fluconazole(PO)
|
100mg daily not exceeded. Exception: IV to
PO switch, HIV/AIDS service, post pancreas transplant
and BMT patients per protocol
|
|
Metronidazole IV
|
500 mg Q12H not exceeded
|
|
Piperacillin/Tazobactam
|
3.375 gm Q6H not exceeded
|
|
Ticarcillin/Clavulanate
|
3.1 gm Q6H not exceeded. Exception: 3.1 gm Q4H
for febrile neutropenia per protocol for Nadir
Sepsis (5N and 2W).
|
|
| Class III |
Antibiotics requiring approval from the appropriate
advisory source regardless of dose.
NOTE: Approval must be obtained prior to the use
of these agents. The department of pharmacy will dispense
emergent doses between 10 pm and 8 am. Sufficient quantity
will be dispensed to maintain the patient until 8am
the following morning, after which approval will be
necessary for subsequent doses.
|
Agent
|
Exception
|
|
Amikacin
|
Class I for Pediatric ICU (6S)
and Burn Unit (8W)
|
|
Amphotericin B
|
Approval required for pediatric use only
|
|
Ampho B Liposomal (Abelcet®)
|
|
|
Antiretrovirals
|
HIV/AIDS service
|
|
Cefepime
|
|
|
Ceftazidime
|
|
|
Cidofovir
|
HIV/AIDS service
|
|
Ciprofloxacin (PO/IV)
|
IV to PO switch and Adult BMT patients per protocol
|
|
Fluconazole (IV)
|
post BMT patients per protocol
|
|
Flucytosine (PO)
|
|
|
Foscarnet
|
|
|
Ganciclovir (PO/IV)
|
prophylaxis per kidney or pancreas transplant
protocol
|
|
Imipenem/Cilastatin
|
|
|
Levofloxacin (PO/IV)
|
IV to PO switch
|
|
Linezolid
|
vancomycin resistance or intolerance
|
|
Meropenem
|
|
|
Pentamidine (IV)
|
HIV/AIDS service and prophylaxis per autologous
BMT protocol
|
|
Quinupristin/Dalfopristin (Synercid®)
|
vancomycin resistance or intolerance
|
|
Ribavirin (INH)
|
|
|
Rifampin (IV)
|
|
|
Vancomycin (Oral)
|
failing or intolerant of oral metronidazole therapy
for C. difficile
|
|
Vancomycin (IV)
|
Automatic stop order after first 96 hours
|
|
Back
to 2000 Antibiogram
|
|
Created:
January 7, 2000.
Revised: January 22, 2002.
© 1998-2002 Steven Pon, MD,
Weill Medical College of Cornell University. All rights reserved.
|
