Download Initials__________ * ED Cellulitis/Skin and Skin Structure Infections

(place patient label here)
Patient Name:_______________________
Order Set Directions:

(√)- Check orders to a ctivate; Order s with pre-c hecked box  will be fo llo we d unless lined out.


Initia l each p lace in the pre-p rinted or der set where cha nges such as ad dit ions, delet ions or line o uts have been made
Initia l each pa ge and Sign/Date/ Time last page
PROVIDER ORDERS
Diagnosis: ________________________________________________________________________________________________
Allergies with reaction type:___________________________________________________________________________________
ED Cellulitis/Skin and Skin Structure Infections
Version 2 8/18/15
This order set is designed for patients that will be admitted.
This order set is
not intended for patients with Severe Sepsis/ Septic Shock-for these patients use the ED Sepsis
order set
Nursing Orders
Vital signs per unit standard
Vital signs non unit standard: __________
Verify that blood and wound cultures have been obtained before starting antibiotics
IV/ Line Insert and/or Maintain
Peripheral IV insert/maintain
IV Fluids - Maintenance
Sodium Chloride 0.9% IV
125 milligram/hour continuous intravenous infusion
Medications
Antibacterial Agents
Community Onset Cellulitis/ Skin and Skin Structure Infections
Benefis Community Onset Cellulitis/ Skin and Skin Structure Infections Empiric Therapy Algorithm (see
attached evidence link)
95% of episodes of beta-hemolytic streptococci
5% of episodes for Staph aureus, including MRSA, but only if abscess is present
First Line Treatment (No Penicillin Allergy) SELECT ALL:
ampicillin-sulbactam (UNASYN)
3 gram intravenously once ; pharmacy to adjust for renal function
clindamycin (CLEOCIN)
900 milligram intravenously once
Penicillin Allergy Options
No Cephalosporin Allergy AND No Anaphylaxis to Penicillin
ceFAZolin (ANCEF)
2 gram intravenously once
clindamycin (CLEOCIN)
900 milligram intravenously once
SELECT ALL:
Cephalosporin Allergy AND/OR Anaphylaxis to Penicillin SELECT vancomycin and clindamycin
**IF vancomycin allergic SELECT one linezolid ONLY
vancomycin
15 milligram/kilogram intravenously once [Max dose = 2 grams]
clindamycin (CLEOCIN)
900 milligram intravenously once
linezolid (ZYVOX)
600 milligram intravenously once
600 milligram tablet orally once
Healthcare-associated Cellulitis/Skin and/or Skin Structure Infections
Initials__________
*
Page 1 of 3
(place patient label here)
Patient Name: ___________________________
Order Set Directions:

(√)- Check orders to a ctivate; Order s with pre-c hecked box  will be fo llo we d unless lined out.

Initia l each p lace in the pre-p rinted or der set where cha nges such as ad dit ions, delet ions or line o uts have been made

Initia l each pa ge and Sign/Date/ Time last page

PROVIDER ORDERS
Benefis Healthcare Associated Cellulitis/ Skin and Skin Structure Infections Empiric Therapy Algorithm (see
attached evidence link)
Examples: IV site related cellulitis and surgical site infection/cellulitis
Empiric coverage needed for Pseudomonas aeruginosa and MRSA
First Line Treatment (No Penicillin Allergy) SELECT ZOSYN and vancomycin ** IF Vancomycin
Allergic replace vancomycin with one linezolid
piperacillin-tazobactam (ZOSYN)
4.5 gram intravenously once ; pharmacy to adjust for renal function
vancomycin
15 milligram/kilogram intravenously once [Max dose = 2 grams]
linezolid (ZYVOX)
600 milligram intravenously once
600 milligram tablet orally once
Penicillin Allergy Options
No Cephalosporin Allergy AND No Anaphylaxis to Penicillin: SELECT cefepime and vancomycin
**IF vancomycin allergic replace vancomycin with one linezolid
cefepime (MAXIPIME)
2 gram intravenously once ; pharmacy to adjust for renal function
vancomycin
15 milligram/kilogram intravenously once [Max dose = 2 grams]
linezolid (ZYVOX)
600 milligram intravenously once
600 milligram tablet orally once
Cephalosporin Allergy AND/OR Anaphylaxis to Penicillin: SELECT aztreonam and vancomycin **
IF vancomycin allergic replace vancomycin with one linezolid
aztreonam (AZACTAM)
2000 milligram intravenously once ; pharmacy to adjust for renal function
vancomycin
15 milligram/kilogram intravenously once [Max dose = 2 grams]
linezolid (ZYVOX)
600 milligram intravenously once
600 milligram tablet orally once
Diabetes Related Foot/ Lower Extremity Infection
Benefis Diabetes Related Foot/Lower Extremity Infections Empiric Therapy Algorithm (see attached evidence
link)
Anticipate polymicrobial mixed aerobic and anaerobic infection
First Line Treatment (No Penicillin Allergy): SELECT:
ampicillin-sulbactam (UNASYN)
3 gram intravenously once ; pharmacy to adjust for renal function
Penicillin Allergy Options
No Cephalosporin Allergy AND No Anaphylaxis to Penicillin: SELECT
cefOXitin (MEFOXIN)
2 gram intravenously once
Cephalosporin Allergy AND/OR Anaphylaxis to Penicillin: SELECT aztreonam and metronidazole
Initials__________
Page 2 of 3
(place patient label here)
Patient Name: ___________________________
Order Set Directions:

(√)- Check orders to a ctivate; Order s with pre-c hecked box  will be fo llo we d unless lined out.

Initia l each p lace in the pre-p rinted or der set where cha nges such as ad dit ions, delet ions or line o uts have been made

Initia l each pa ge and Sign/Date/ Time last page

PROVIDER ORDERS
and vancomycin **IF vancomycin allergic replace vancomycin with one linezolid
aztreonam (AZACTAM)
2000 milligram intravenously once ; pharmacy to adjust for renal function
metroNIDAZOLE (FLAGYL)
500 milligram intravenously once
vancomycin
15 milligram/kilogram intravenously once [Max dose = 2 grams]
linezolid (ZYVOX)
600 milligram intravenously once
600 milligram tablet orally once
Laboratory
Select the following only if not already done
CULTURE, BLOOD
x 2 from 2 different sites 5 minutes apart
CULTURE, WOUND AND GRAM STAIN MIC Source: ______________________
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Provider_Signature:_____________________________________________Date:__________Time:_________
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