Hop qdrp antibiotic tables (poster) color - for 7-11 through 12-1

Specifications Manual for Hospital Outpatient Department Quality Measures v.4.1 Prophylactic Antibiotic Regimen
Selection for Surgery
07-01-2011 (3Q11) through 12-31-2011 (4Q11)
Surgical Procedure
Approved Antibiotics
(Appendix A)
(Appendix C)
Cardiac (Pacemakers or AICDs) or Vascular
OP Table 6.1
Cefazolin or Cefuroxime OP Table 6.6 or Vancomycin* OP Table 6.12
If β-lactam allergy: Vancomycin OP Table 6.12 or Clindamycin OP Table 6.7
Orthopedic/Podiatry
Cefazolin or Cefuroxime OP Table 6.6
OP Table 6.2
or Vancomycin* OP Table 6.12
If β-lactam allergy: Vancomycin OP Table 6.12 or Clindamycin OP Table 6.7
Genitourinary
Quinolone† OP Table 6.11
OR 1st Generation cephalosporin OP Table 6.6a
OP Table 6.3
OR 2nd Generation cephalosporin OP Table 6.6b
OR 3rd Generation cephalosporin OP Table 6.6c
Prostate biopsy
OR Aminoglycoside OP Table 6.2 + Metronidazole OP Table 6.9
OR Aminoglycoside OP Table 6.2 + Clindamycin OP Table 6.7
OR Aztreonam OP Table 6.5 + Metronidazole OP Table 6.9
OR Aztreonam OP Table 6.5 + Clindamycin OP Table 6.7
Ampicillin/Sulbactam or Ticarcillin/Clavulanate or Pipercillin/Tazobactam OP Table 6.3
OR Aminoglycoside OP Table 6.2 + 1st Generation cephalosporin OP Table 6.6a
OP Table 6.3a
OR Aminoglycoside OP Table 6.2 + 2nd Generation cephalosporin OP Table 6.6b
OR Aminoglycoside OP Table 6.2 + Vancomycin OP Table 6.12
Penile prosthesis insertion,
OR Aminoglycoside OP Table 6.2 + Clindamycin OP Table 6.7
removal, revision
OR Aztreonam OP Table 6.5 + 1st Generation cephalosporin OP Table 6.6a
OR Aztreonam OP Table 6.5 + 2nd Generation cephalosporin OP Table 6.6b
OR Aztreonam OP Table 6.5 + Vancomycin OP Table 6.12
OR Aztreonam OP Table 6.5 + Clindamycin OP Table 6.7
Gastric/Biliary
Cefazolin OP Table 6.6
OR Cefuroxime OP Table 6.6
OR Cefoxitin OP Table 6.4
OR Cefotetan OP Table 6.4
OP Table 6.4
OR Ampicillin/Sulbactam OP Table 6.3a
OR Cefazolin OP Table 6.6 + Metronidazole OP Table 6.9
PEG placement
OR Cefuroxime OP Table 6.6 + Metronidazole OP Table 6.9
OR Vancomycin* OP Table 6.12
If β-lactam allergy:
Clindamycin OP Table 6.7 +/- Aminoglycoside OP Table 6.2
OR Clindamycin OP Table 6.7 +/- Quinolone OP Table 6.11
OR Vancomycin OP Table 6.12 +/- Aminoglycoside OP Table 6.2
OR Vancomycin OP Table 6.12 +/- Quinolone OP Table 6.11
Gynecological
Cefazolin or Cefuroxime OP Table 6.6, Cefoxitin or Cefotetan OP Table 6.4
OP Table 6.5
or Ampicillin/Sulbactam OP Table 6.3a
If β-lactam allergy:
Laparoscopically-assisted
Metronidazole OP Table 6.9 + Aminoglycoside OP Table 6.2
hysterectomy, Vaginal
OR Metronidazole OP Table 6.9 + Quinolone OP Table 6.11
OR Clindamycin
hysterectomy
OP Table 6.7 + Aminoglycoside OP Table 6.2
OR Clindamycin OP Table 6.7 + Aztreonam OP Table 6.5
OR Clindamycin OP Table 6.7 + Quinolone OP Table 6.11
1st Generation Cephalosporin OP Table 6.6a
OR 2nd Generation Cephalosporin OP Table 6.6b
OR Ampicillin/Sulbactam OP Table 6.3a
OP Table 6.5a
OR Quinolone† OP Table 6.11
If β-lactam allergy:
Pubovaginal sling
Aminoglycoside OP Table 6.2 + Clindamycin OP Table 6.7
OR Aminoglycoside OP Table 6.2 + Metronidazole OP Table 6.9
OR Aztreonam OP Table 6.5 + Clindamycin OP Table 6.7
OR Aztreonam OP Table 6.5 + Metronidazole OP Table 6.9
Head & Neck
Cefazolin or Cefuroxime
OP Table 6.6
OR Clindamycin OP Table 6.7 +/- Aminoglycoside OP Table 6.2
OR Vancomycin* OP Table 6.12
Neurological
OP Table 6.7
Nafcillin or Oxacillin OP Table 6.8, Cefazolin or Cefuroxime OP Table 6.6,
or Vancomycin* OP Table 6.12 or Clindamycin OP Table 6.7
Special Considerations
*Vancomycin is acceptable with a physician/APN/PA/pharmacist documented justification for its use (see data element Vancomycin).
†The only operations for which oral antibiotics alone are acceptable are the Prostate biopsy and Pubovaginal sling procedures
PLEASE NOTE: Highlighted materials in yellow indicate new additions to the table.
This material was prepared by FMQAI, the Support Center for the Hospital Outpatient Quality Data Reporting Program (HOP QDRP), under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). The contents presented do not necessarily reflect CMS policy. FL-9SOW-2011SS1T11-2-12127

Source: http://hospitaloqr.org/media/HOP%20QDRP%20Antibiotic%20Tables%20(poster)%20color%202-10-11(checked).pdf