Sepsis
Update your SEPSIS protocols
As a critical care pharmacist, you will hear ongoing debate about MANAGING SEPSIS IN ADULTS. Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Update your protocols using the latest data... Fluids Verify your sepsis order set includes balanced fluids ( Lactated Ringer's, Plasma-Lyte, etc…
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UTI
Antibiotics for urinary tract infections in ELDERLY patients
As a clinical pharmacist, you will be asked more, which antibiotics should be recommended for urinary tract infections in elderly patients? It depends on whether it's a "complicated" UTI or not. We know all UTIs in older MEN are considered complicated due to possible prostate involvement. UTIs in women can also be complicated due to a catheter, obstr…
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Respiratory and Allergy
Chronic azithromycin to PREVENT COPD exacerbations
As a hospital pharmacist, you will see some patients taking chronic azithromycin to PREVENT recurrent COPD exacerbations. Preventing acute COPD exacerbations is a BIG deal. Each exacerbation worsens lung function and quality of life, plus the 30-day mortality rate is higher after a severe COPD exacerbation than a heart attack. …
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Infectious Diseases
Help manage Candida auris
As a critical care pharmacist, you should know how to manage the multidrug-resistant yeast and Candida auris . C. auris can be fatal in up to about 60% of patients. It spreads easily, contaminates surfaces and is tough to eliminate. Plus it’s difficult to identify C. auris . It can mistakenly be reported as another yeast, especially Candida haemulonii . …
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Respiratory and Allergy
Treating serious STREP infections
As a clinical pharmacist, The uptick in severe cases will raise questions about how to treat Group A strep . We generally think of this bug causing strep throat, or skin infections. Most cases are mild, or some patients are asymptomatic carriers. But there’s a rise in serious infections, such as necrotizing fasciitis and toxic shock syndrome. The increase may be due…
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Infectious Diseases
Helping patients cope with long COVID
As a clinical pharmacist, patients will need your help managing long COVID, when symptoms linger more than 12 weeks after initial infection. COVID-19 can leave lasting effects anywhere in the body, causing "brain fog", diarrhea , shortness of breath, etc. Symptoms seem to be more common in patients who’ve had severe COVID-19 (hospitalized, etc), a repeat in…
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Infectious Diseases
How to treat FUNGAL NAIL infections
As a community pharmacist, patients will ask you how to get rid of fungal nail infections. They get frustrated with treatments that often don't work, or when the infection comes back after an initial improvement. Help patients sort through their options.. Oral antifungals are the most effective. Start with oral terbinafine ( Lamisi…
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Infectious Diseases
Manage ENDOcarditis due to injection drug use
As a hospital pharmacist, you will see a new focus on treating endocarditis in people who inject drugs, as cases continue to rise due to the opioid epidemic. Recent American Heart Association (AHA) guidance emphasizes a holistic approach , including antimicrobials AND treatment of substance use disorder. Continue to tailor …
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Oncology
Act FAST when treating febrile neutropenia
As a clinical pharmacist, you should act fast when treating febrile neutropenia. Febrile neutropenia in patients with cancer is a medical emergency, since delays in care are linked to increased mortality. These patients have an isolated temp of 101°F or higher OR a temp of 100.4°F or higher for at least an hour. PLUS, an absolute neutrophil count (ANC) currently bel…
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Infectious Diseases
Empiric antibiotics for intra-abdominal infections
Complicated intra-abdominal infections are problems in clinical practice and consume substantial hospital resources. New guidelines will clarify appropriate antibiotics for empiric treatment of complicated intra-abdominal infections ... Community-acquired infections For appendicitis and other mild to moderate community infections use a single age…
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Sepsis
Meronem dose is easier than Tienam in renal failure
As a clinical pharmacy specialist, doctors will often ask you about the difference between Meronam and Tienam . And how to adjust the doses of each in patients with kidney impairment... Imipenem ( Tienam ) is the first carbapenem, was marketed in 1987. It is more active against Gram-positive cocci. While meropenem ( Meronem ) is more a…
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Infectious Diseases
Antibiotic use for SKIN infections
As a clinical pharmacist, you will get questions about empiric antibiotic choices for patients hospitalized with skin infections. These patients may have more severe infections or have failed oral therapy. Broad-spectrum empiric antibiotics are often started, but they aren't always needed. Work with your antimicrobial stewardship team to limit antibiotic options…
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Infectious Diseases
Treat ENDOcarditis patients
As a clinical pharmacist, you will see changes in endocarditis treatment due to new guidelines. Infective endocarditis (IE) refers to infection of the endocardial surface of the heart, most often the heart valves, particularly prosthetic heart valves. The great majority of cases are caused by staphylococci or streptococci and …
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