COVID treatment guideline update
/New GLA COVID treatment guidelines are posted in the “Guidelines” section that reflect deauthorization of bebtelovimab and weighing evidence of benefit of Evusheld vs. circulating variants.
New antimicrobial approval phone!
/The old antimicrobial approval pager has been retired! The new antimicrobial approval phone number is 323-891-5282. Can call or text during regular business hours.
New monkeypox guidance!
/New monkeypox guidance is now available under the “Guidelines” tab. More to follow!
New antibiogram!
/The GLA antibiogram for calendar year 2021 is here! Some highlights:
For Gram-negative rods in the hospital setting:
Carbapenem-resistant Enterobacteriaceae remain relatively uncommon at GLA
Amikacin remains most active agent vs. multi-drug resistant Gram-negative rod infections at GLA, despite P. aeruginosa susceptibility decreasing somewhat (2020: 100%; 2021: 92%)
If specific coverage for Pseudomonas is warranted, piperacillin-tazobactam provides more coverage (87%) than cefepime (61%) and meropenem (61%), though meropenem and ertapenem have better coverage against non-Pseudomonas Gram-negative nosocomial isolates
Fluoroquinolone susceptibility versus most nosocomial Gram-negative organisms remains relatively poor and ceftriaxone susceptibility among urine nosocomial Gram-negatives is variable.
For Gram-negative rods in the outpatient setting:
Cefazolin susceptibility among common urinary Enterobacteriaceae is not readily captured but susceptibility rates among other beta-lactams remain relatively stable
Fluoroquinolone and TMP-SMX susceptibilities remain largely stable
Key trends among Gram-positive isolates:
MRSA 56% of nosocomial non-blood isolates, 47% of nosocomial blood isolates
MRSA ~40% outpatient non-blood isolates
Doxycycline susceptibility remains stable among non-blood S. aureus isolates (83% nosocomial, 90% outpatient)
COVID-19 Treatment Updates
/New GLA treatment guidelines for COVID-19 are now available under the “Guidelines” tab. Notable items include criteria for use of Paxlovid, sotrovimab, molnupiravir, updated remdesivir indications, and anticoagulation considerations.