Your EMR may offer you a “helpful” allergy warning when ordering a carbapenem because your patient is allergic to penicillins or cephalosporins; the cross reactivity is very low and most people tolerate carbapenems with a low risk of allergic reaction.
Your EMR may offer you a “helpful” allergy warning when ordering a carbapenem because your patient is allergic to penicillins or cephalosporins; the cross reactivity is very low and most people tolerate carbapenems with a low risk of allergic reaction.
Add anti-MRSA only for a real risk factor — it is not routine in CAP. Risks: prior MRSA (infection, colonization, or positive nasal PCR); hospitalization or IV antibiotics ≤90 days; severe, necrotizing, or cavitary pneumonia; empyema; recent influenza; ESRD/dialysis; injection drug use. Negative nasal PCR (NPV ~95–99%) → reasonable to withhold or stop.
VancomycinMRSA
???
Monitor: target AUC/MIC 400–600; check a level before the 4th dose.
Scope: soft-tissue infection without evidence of osteomyelitis. Probe-to-bone or exposed bone suggests osteomyelitis — treat as osteomyelitis (different workup and a longer course).
Group A○Pick onerequired
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Anti-MRSA○Pick onerequired
Group A
Imipenem-Cilastatin
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Your EMR may offer you a “helpful” allergy warning when ordering a carbapenem because your patient is allergic to penicillins or cephalosporins; the cross reactivity is very low and most people tolerate carbapenems with a low risk of allergic reaction.
Your EMR may offer you a “helpful” allergy warning when ordering a carbapenem because your patient is allergic to penicillins or cephalosporins; the cross reactivity is very low and most people tolerate carbapenems with a low risk of allergic reaction.