APPENDICITIS

What is your rationale for going straight to Vanco as an abx choice?

The usual orders I see are IV, labs, NS, zofran 4mg, morphine 4mg (adults) x 3 doses, CT, surgical consult. We don't give antibiotics initially and transition to LR only after 2L of NS. We also will switch to Dilaudid if the morphine clearly isn't working.

I use Vancomycin as it is our surgeons #1 choice for appendicitis.

I use Vancomycin as it is our surgeons #1 choice for appendicitis.

Really? There are much better options out there

Does seem like a strange order for an appendix. Tough on veins and not exactly keeping the big guns for when they are really needed. I've typically seen cefotetan or levaquin + flagyl.

I second the Levaquin and Flagyl, NS, and the higher doses of pain meds

CT, R/O sepsis/abscess, pain meds, common gut bacteria antibiotics (flagyl, etc).

We no longer get a surgical consult as part of the standard protocol since we typically no longer move towards surgical interventions in appendicitis as a general rule.

We no longer get a surgical consult as part of the standard protocol since we typically no longer move towards surgical interventions in appendicitis as a general rule.

What do you do for appendicitis at your place of work?

Really? There are much better options out there

Agreed. At my hospital we generally give Zosyn for appendicitis. I have never given Vancomycin to someone with an appy, seems like overkill to me.

IV, zofran, morphine, fluids (1-2L if lots of vomiting), and typically 1G Invanz prior to OR.

What do you do for appendicitis at your place of work?

In uncomplicated appendicitis we use only antibiotics initially, a portion of those will require surgery but for the majority antibiotics is the only treatment required.Appendicitis Treatment with Antibiotics by Dr. Marks on MedicineNet.com

I use Vancomycin as it is our surgeons #1 choice for appendicitis.

Then aren't the surgeons ordering it ... you know, after they see the patient, confirm that it is a surgical case, and accept the patient?

This is not making a whole lot of sense to me, coming from a provider.