title: Rationale and experience in treating suspected hospital-based mixed infections.
abstract: Ochsner Foundation Hospital of the Ochsner Medical Institutions (OMI), a 532-bed tertiary care facility in New Orleans, uses a formulary review process common to many institutions. Considered in the selection of antimicrobial therapy are efficacy, safety, and cost. At OMI, ticarcillin-clavulanate plus gentamicin are the standard broad-spectrum antimicrobial agents for initial treatment of suspected mixed infections. The pharmacy department provides an aminoglycoside-monitoring program and convenient dosing guidelines. The regimen has resulted in good therapeutic outcomes and few adverse effects. Bacterial resistance has not been detected. Future plans include a large-scale concurrent review of patient outcomes, resistance patterns, and rates of fungal overgrowth associated with these agents.
authors.affiliation: Department of Pharmacy, Ochsner Medical Institutions, New Orleans, LA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Billeter
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002969:Clavulanic Acids / Q000627:therapeutic use; D002985:Clinical Protocols; D003428:Cross Infection / Q000188:drug therapy*; D004334:Drug Administration Schedule; D016903:Drug Monitoring; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D017723:Drug Utilization Review; D005572:Formularies, Hospital as Topic; D005839:Gentamicins / Q000627:therapeutic use; D006746:Hospital Bed Capacity, 500 and over; D006784:Hospitals, Teaching; D006801:Humans; D008145:Louisiana; D010607:Pharmacy Service, Hospital; D015163:Superinfection / Q000188:drug therapy / Q000517:prevention & control; D013982:Ticarcillin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D002969:Clavulanic Acids; D005839:Gentamicins; C043215:ticarcillin-clavulanic acid; D013982:Ticarcillin