Approved Hospital Formulary
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Approved Hospital Formulary
2/10/25 HH Main ED Vancomycin Change
February 10, 2025
Good afternoon, pharmacists
I just wanted to reach out to update you all on changes with vancomycin in the emergency department. Note that this only applies to HH Main emergency department.
Part of my major project has been identifying problems and potential solutions for sepsis management within the ED.
One thing I was able to find is that vancomycin doses are often given late in the ED. Most of these late doses are vancomycin orders that come from PSP, not from the ED Pyxis machines.
We have been able to obtain additional commercially available vancomycin products and have updated inventory in the ED Pyxis machines and these have been flexed in Med Manager.
Most ED Pyxis machines should now have 1000 mg, 1500 mg, and 2000 mg routinely stocked.
If you get an order to start vancomycin in the ED, please try your best to round the dose to one of these that are available within the ED.
There is a larger multidisciplinary project to update the sepsis advisor and create sepsis powerplans, but we are not making any changes to dosing policies or protocols right now.
As always, use your clinical judgement for these doses. If you have a very large patient, you can still give them a higher loading dose. Just keep in mind that it will still have to come from PSP.
Due to limitations in space in the ED refrigerators, we are not able to stock any other doses (and there are no commercially available products > 2 g). When I reviewed data, there was only a small percentage of patients that received >2 g.
Please let me know if you have any questions or suggestions on this process!
Thank you and have a great day,
Evan Lawson, PharmD
PGY-2 Infectious Diseases Pharmacy Resident
Huntsville Hospital
Office: (256) 265-0018
evan.lawson@hhsys.org
PGY-2 Infectious Diseases Pharmacy Resident
Huntsville Hospital
Office: (256) 265-0018
evan.lawson@hhsys.org