I was wondering if anyone could provide recommendations on best practices for 
initial antibiotic dosing in sepsis. We have always been aggressive upfront 
with antibiotics but our antibiotics stewardship team is appropriately 
questioning if we should continue this practice.
Should we use a "one-dose-fit-all approach" for everyone or should we dose 
adjust based on organ dysfunction, drug toxicity, drug pk/pd, fluid status, etc.
The one dose approach did help with timeliness of antibiotic administration 
since we could stock medications in Pyxis.
Any suggestions welcome
Thanks
Fiona

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Sent: Friday, July 31, 2015 2:14:08 PM
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Subject: Sepsisgroups Digest, Vol 165, Issue 4

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Today's Topics:

   1. Blood Cultures from Central Lines (Angela Craig)


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Message: 1
Date: Fri, 31 Jul 2015 08:02:08 -0500
From: Angela Craig <[email protected]>
To: "'[email protected]'"
        <[email protected]>
Subject: [Sepsis Groups] Blood Cultures from Central Lines
Message-ID:
        
<343E31412FC9094487B54371286ADDA03532BCF20C@D109EXCHMB.crmchealth.hospital>

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Is everyone out there getting one set of blood cultures from the central line 
if the line has been placed >48 hours? per the guidelines (see below)?

If so - have you seen an increase in your CLABSI rates due to the risk of false 
positive blood cultures when collected from the line??  Anyone getting 
encouragement from Infection Control to only get cultures if the line is the 
suspected source per IDSA/CDC guidelines??


C. Diagnosis

1. Cultures as clinically appropriate before antimicrobial therapy if no 
significant delay (> 45 mins) in the start of antimicrobial(s) (grade 1C). At 
least 2 sets of blood cultures (both aerobic and anaerobic bottles) be obtained 
before antimicrobial therapy with at least 1 drawn percutaneously and 1 drawn 
through each vascular access device, unless the device was recently (<48 hrs) 
inserted (grade 1C).




Angela Craig  APN, MS, CCNS
CNS for ICU
Cookeville Regional Medical Center
931-783-5035

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