Focusing on severe sepsis and septic shock as defined by CMS, we are interested in administering broad-spectrum antibiotic coverage (which typically will require at least two different antibiotics) as rapidly as possible. Often times, antibiotics are Y-site compatible making it feasible to administer two antibiotics simultaneously. However, there is a theoretical concern that a patient could develop an allergic reaction, and if both antibiotics were infusing simultaneously, it would be difficult to determine which antibiotic is responsible for the reaction. On the flip side, true allergic reactions are exceedingly rare with common antibiotics used and in critically-ill patients the pros and cons may lean towards simultaneous administration. I am aware that certain antibiotics are infused over 5 minute IVP versus 30 minute IVPB vs. 2 hours infusions, and want to refrain from discussing those factors in the poll below as #1, #2, #3 below still apply regardless.

Poll:

Does you hospital:
1. Require different antibiotics to be administered sequentially in the ER (error on the side of possible allergic reactions and less concern for rapid administration)
2. Allow simultaneous administration of different antibiotics in the ER (error on the side of rapid administration and less concern for possible allergic reactions)
3. Does not have a policy that addresses this and it’s up to the ER RN

If willing, please include your hospital name (not mandatory however).

We will compile the results and email them out to everyone that responds in the form of an excel file.

Thanks!