vanco prophylaxis question for you surgeons

[psurocks]

Ok, so im a pharmacist in training and I have a question bout orthapedes....obviously I know zilch about surgery, however I do know the drugs (duh!)....so heres the question, isnt the current standard of practice to give pt Ancef prophylatically and only give vanco if there is a allergy? We have a orthapedist who gives everyone vanco, and this doesnt seem right.

I was at a meeting, and the MD there said that give Ancef, but one *could* get away with giving Vanco if pt + for MRSA nasal swab, which I guess Im ok with


what are your guys thoughts and what do some of you use?

thanks!

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[ddmo]

The standard orthopaedic prophylaxis at my hospital is Ancef (Kefzol), for a total of 3 doses. If you are allergic you get Clindamycin or Vanco depending on the surgeon's preference. Or you get Vanco if there is an indication like MRSA infection.

 

[Tired]

For the OP, what's the percentage of staph cultures in your hospital that are MRSA?

 

[psurocks]

our mrsa rates are below the avg (which is good)

and from my understanding, non MRSA staph is better taken care of from ancef anyways

in other words, i guess all im asking is tat if there is no allergy, is there any proven reason to prophylax with vanco and not ancef

 

[Tired]

our mrsa rates are below the avg (which is good)

and from my understanding, non MRSA staph is better taken care of from ancef anyways

in other words, i guess all im asking is tat if there is no allergy, is there any proven reason to prophylax with vanco and not ancef

I agree. In the absence of dramatic MRSA rates or allergy, the use of Vanc as a first-line agent is unnecessary and outside published guidelines on surgical antibiotic prophylaxis.