Medicine and Health Sciences Commons^™

Compatibility Of Vancomycin And Oxacillin During Simulated Y-Site Delivery, Hilary Teibel, Chad Knoderer, Kristen Nichols

Kristen R. Nichols

Background: Vancomycin and oxacillin may be used together as empiric coverage in patients with proven or suspected Staphylococcus aureus infections. Though vancomycin hydrochloride 20 mg/mL and oxacillin sodium 160 mg/mL are reported to be compatible via Y-site delivery, Y-site compatibility of commonly used concentrations, vancomycin 10 mg/mL and oxacillin 20 mg/mL, has not yet been reported. Objective: To determine the Y-site compatibility of vancomycin 10 mg/mL and oxacillin 20 mg/mL. Methods: One vancomycin hydrochloride 1 g vial was reconstituted with 10 mL sterile water for injection (SWFI) and diluted with 90 mL 5% dextrose in water (D5W) in an evacuated …

Linezolid-Associated Thrombocytopenia In Children With Renal Impairment, Sara Jones, Kristen Nichols, Heather Deyoung, Elaine Cox, Chad Knoderer

Kristen R. Nichols

Impaired renal function has been associated with an increased risk of thrombocytopenia in adults receiving linezolid. Findings from this retrospective cohort demonstrate an association between thrombocytopenia and lower creatinine clearance in children receiving linezolid.

Y-Site Compatibility Of Vancomycin And Piperacillin/ Tazobactam At Commonly Utilized Pediatric Concentrations, Kristen Nichols, Michael Demarco, Michael Vertin, Chad Knoderer

Kristen R. Nichols

Background: Vancomycin and piperacillin/tazobactam are common empiric antibiotics in hospitalized pediatric patients. Studies evaluating intravenous (IV) compatibility at various concentrations show inconsistent results. Objective: The objective of this study was to determine the Y-site compatibility of vancomycin 10 mg/mL and piperacillin/tazobactam 112.5 mg/mL. Methods: Vancomycin (10 g vial) was reconstituted using sterile water for injection (SWFI) and diluted with 5% dextrose in water (D5W) to a final concentration of 10 mg/mL in an evacuated IV bag. Piperacillin/tazobactam (40.5 g vial) was reconstituted and diluted with SWFI to a final concentration of 112.5 mg/mL (100 mg/mL piperacillin) in an evacuated IV …

Conversion Of A Single-Facility Pediatric Antimicrobial Stewardship Program To Multi-Facility Application With Computerized Provider Order Entry And Clinical Decision Support, E. Webber, H. Warhurst, S. Smith, E. Cox, A. Crumby, Kristen Nichols

Kristen R. Nichols

Objective: Antimicrobial stewardship programs (ASPs) help meet quality and safety goals with regard to antimicrobial use. Prior to CPOE implementation, the ASP at our pediatric tertiary hospital developed a paper-based order set containing recommendations for optimization of dosing. In adapting our ASP for CPOE, we aimed to preserve consistency in our ASP recommendations and expand ASP expertise to other hospitals in our health system.

Methods: Nine hospitals in our health system adopted pediatric CPOE and share a common domain (Cerner Millenium™). ASP clinicians developed sixty individual electronic order sets (vendor reference PowerPlans™) to be used independently or as …

Cinacalcet Administration By Gastrostomy Tube In A Child Receiving Peritoneal Dialysis, Kristen Nichols, Chad Knoderer, Bethanne Johnston, Amy Wilson

Kristen R. Nichols

A 2-year-old male with chronic kidney disease with secondary hyperparathyroidism developed hypercalcemia while receiving calcitriol, without achieving a serum parathyroid hormone concentration within the goal range. Cinacalcet 15 mg (1.2 mg/kg), crushed and administered via gastrostomy tube, was added to the patient’s therapy. This therapy was effective in achieving targeted laboratory parameters in our patient despite instructions in the prescribing information that cinacalcet should always be taken whole.