Spectrum: Local Antimicrobial Stewardship, for Lake of the Woods District Hospital

Supportive Care

Supportive Care

Reassess currrent antibiotic treatment and discontinue all PO/IV antibiotics

May be some exceptions

Fecal Management System for incontinent patients

Discontinue all laxatives and stool softeners

  • Sennosides

  • Docusate

  • Milk of magnesia

Discontinue all anti-diarrheal agents

  • Loperamide (Immodium),

  • Diphenoxylate/Atropine (Lomotil)

Consider discontinuing proton pump inhibitors and H2 Blockers

Consider discontinuing anti-motility agents

  • Metocloptamide (Maxeran)

  • Domperidone (Motilium)

  • Narcotics

Consider toxin binder/stool bulking agent

  • Cholestyramine 4g PO TID

  • Give at least 2 hrs before or after oral vancomycin dose

Consider Probiotic

Lactobacillus/Bifidobacterium 1 cap PO TID
OR
Florastor (Saccharomyces boulardii) 1 cap PO BID

  • Give Probiotics at least 2 hours before or after antibiotics

  • Suggested to restrict probiotics to non-pregnant, immune competent patients without prosthetic heart valves and outside of ICU